Cell-based assay for determining activity in the retinoblastoma pathway

ABSTRACT

Disclosed are methods of determining activity of CDK4 and CDK6 variants upon exposure to CDK inhibitors, methods for determining activity of a Rb variant, methods for determining the activity of a p16 variant in a cell, and methods for determining the sensitivity of a CDK4 variant or a CDK6 variant to p16 in a cell. Stable cell lines for determining activity of CDK4 variants, CDK6 variants, Rb variants, and p16 variants are also disclosed.

CROSS REFERENCE TO RELATED APPLICATION

This application is a continuation of co-pending U.S. application Ser. No. 16/192,993 filed on Nov. 11, 2018. U.S. Ser. No. 16/192,993 claimed the benefit of Provisional Application No. 62/587,107 filed on Nov. 16, 2017 and Provisional Application No. 62/756,750 filed on Nov. 7, 2018. The entirety of each application is incorporated herein by reference.

FIELD OF THE INVENTION

The present invention generally relates to a cell-based assay useful for determining the activity of CDK4, CDK6, Rb, and p16, and their respective variants. The novel cell-based assay is useful in screening CDK4 and CDK6 inhibitors and predicting patient response to treatment with CDK targeted inhibitors.

BACKGROUND OF THE INVENTION

The cyclin-dependent kinases are serine/threonine protein kinases which are the driving force behind the cell cycle and cell proliferation. Specifically, CDK4 and CDK6 (CDK4/6) is a catalytic subunit of the protein kinase complex that is important for cell cycle G1 phase progression. The activity of this kinase is restricted to the G1-S phase, which is controlled by the regulatory subunits D-type cyclins and CDK inhibitor p16. An additional protein in the cell cycle is the retinoblastoma (Rb) protein (a negative regulator and tumor suppressor). Rb protein also leads to transcriptional activation in the cell and the eventual progression into S phase. (Phadke and Thomas, OncLive, October 2014). In general, activated CDKs mediate regulatory functions by phosphorylating cellular proteins, usually on serine or threonine residues. Uncontrolled proliferation is a hallmark of cancer cells, and misregulation of CDK function occurs in a variety of solid tumors. CDK4/6 are of particular interest because the associated activities are frequently misregulated in a wide variety of cancers.

CDK4/6 act as a serine/threonine kinase that phosphorylates Rb. Naturally occurring Rb mutants lack the ability to bind to and regulate E2F (Qian et al., 1992). Binding of Rb to E2F1 inhibits eukaryotic E2F mediated transcription that is promoted through E2F activity. However, CDK-mediated phosphorylation of Rb dissociates Rb from E2F1, thereby allowing transcription to occur. When cells are lacking functional Rb they have tendency to be resistant to natural inhibitor p16 (Medema et al., 1995) and to CDK4 and/or CDK6 inhibitors (Sherr et al., 2016). When cells are treated with Palbociclib (Ribociclib or Abemaciclib) and CDK4/6 is inhibited, Rb phosphorylation is prevented and allows for the Rb/E2F1 complex that inhibits transcription and decreases the growth and replication of the cell, thereby inhibiting cancer cells. p16 is a natural inhibitor of CDK4 and CDK6 and as a result plays very important role in the CDK4/CDK6 pathway. When cells lack functional p16 they tend to be susceptible to cancer. CDKN2A (the gene which encodes p16 protein) somatic alterations occur in more than 50% of human tumors (including inherited mutations in melanoma and pancreatic carcinoma) and the majority of these mutations have only been observed in a single family. Since many somatic gene mutations in the Rb pathway will result in a “loss of function” protein, it is important to have a functional assay to determine where in the pathway the mutation is and how that specific mutant protein responds to treatment.

To treat complex diseases effectively, a systems-level approach is needed to understand the interplay of intracellular signals and cellular behaviors that underlie disease states. This approach requires high-throughput, multiplex techniques that measure quantitative temporal variations of multiple protein activities in the intracellular signaling network. Accordingly, there remains a need for a personalized medicine approach utilizing cell-based assays and methods to screen the efficacy of CDK4/6 inhibitors on individual patients to determine the best treatment for that individual patient.

SUMMARY OF THE INVENTION

In one aspect, the present invention concerns a method of determining the effect of a CDK inhibitor on a CDK variant, comprising the steps of:

-   -   a. preparing a first cDNA of a CDK variant, wherein said CDK         variant contains at least one mutation as compared to wild-type         CDK;     -   b. providing a mammalian cell, said cell comprising a knockout         of endogenous CDK, and a first construct stably integrated into         said mammalian cell, wherein said first construct comprises a         second cDNA encoding E2F1 protein which is linked to Dp-1         protein and a first portion of a luciferase gene at its         C-terminus;     -   c. transfecting into said mammalian cell said first cDNA from         step a);     -   d. transfecting into said mammalian cell a third cDNA encoding         Cyclin D1 and a second construct, comprising a fourth cDNA of         encoding Rb protein which is linked to a second portion of a         luciferase gene at its N-terminus, wherein when said first         construct is in close proximity with said second construct a         complex is formed that emits light;     -   e. exposing said transfected cell with a CDK inhibitor; and     -   f. measuring any generated light emission, wherein an increase         in light emission relative to said CDK inhibitor is indicative         of said CDK variant being susceptible to treatment with said CDK         inhibitor.

In another aspect, the present invention concerns a method of determining the activity of a Rb variant in a cell, comprising the steps of:

-   -   a. providing a mammalian cell, said cell comprising a stably         integrated first construct, wherein said first construct         comprises a first cDNA encoding E2F1 protein which is linked to         a first portion of a luciferase gene, and a second cDNA encoding         Dp-1 protein;     -   b. preparing a linear third cDNA of a Rb variant, wherein said         Rb variant contains at least one mutation as compared to         wild-type Rb, and said third cDNA is linked to a second portion         of a luciferase gene to form a second construct, wherein when         said first construct is in close proximity with said second         construct a complex is formed that emits light;     -   c. transfecting said second construct into said mammalian cell;         and     -   d. determining the activity of said Rb variant by measuring any         generated light emission, wherein an increase in light emission         relative to a control mammalian cell is indicative of said Rb         variant activity.

In another aspect, the present invention concerns a method of determining the activity of a p16 variant in a cell comprising the steps of:

-   -   a. providing a mammalian cell, said cell having a knockout of         endogenous CDK4 and endogenous CDK6, and a first construct         stably integrated into said mammalian cell comprising a first         cDNA encoding E2F1 protein linked to Dp-1 protein and a first         portion of a luciferase gene at its C-terminus;     -   b. preparing a second construct comprising a second cDNA         encoding Rb protein which is linked to a second portion of a         luciferase gene at its N-terminus, wherein when said first         construct is in close proximity with said second construct a         complex is formed that emits light;     -   c. preparing a third cDNA encoding Cyclin D1 protein and a         fourth cDNA encoding CDK4 protein or CDK6 protein;     -   d. preparing a fifth cDNA of a CDKN2A variant, said CDKN2A         variant having at least one mutation as compared to wild-type         CDKN2A;     -   e. preparing a transfection complex, said transfection complex         comprising said second construct, said third cDNA, said fourth         cDNA, and said fifth cDNA;     -   f. transfecting said transfection complex into said mammalian         cell, wherein said transfection is transient; and     -   g. determining the activity of said p16 variant by measuring any         generated light emission, wherein an increase in light emission         relative to a mammalian cell control is indicative of said p16         variant activity.

In another aspect, the present invention concerns a method of determining the sensitivity of a CDK4 variant or a CDK6 variant to p16 in a cell, comprising the steps of:

-   -   a. providing a mammalian cell, said cell having a knockout of         endogenous CDK4 and endogenous CDK6, and a first construct         stably integrated into said cell, said first construct         comprising a first cDNA encoding E2F1 protein linked to Dp-1         protein, wherein said Dp1 protein is linked to a first portion         of a luciferase gene at its C-terminus;     -   b. preparing a second cDNA of a CDK4 or CDK6 variant from a         patient, said CDK4 variant or CDK6 variant containing at least         one mutation as compared to wild-type CDK4 or wild-type CDK6;     -   c. preparing a second construct comprising a third cDNA encoding         Rb protein which is linked to a second portion of a luciferase         gene at its N-terminus, wherein when said first construct is in         close proximity with said second construct a complex is formed         that emits light;     -   d. preparing a fourth cDNA encoding Cyclin D1 protein;     -   e. preparing a fifth cDNA of wild-type CDKN2A;     -   f. preparing a transfection complex comprising said second         construct, said third cDNA, said fourth cDNA, and said fifth         cDNA;     -   g. transfecting said transfection complex into said mammalian         cell, wherein said transfection is transient; and     -   h. determining whether said CDK4 or CDK6 variant is sensitive to         p16 by measuring any generated light emission, wherein an         increase in light emission relative to a mammalian cell control         is indicative of said CDK4 or CDK6 variant being sensitive to         p16.

In another aspect, the present invention concerns a cell line comprising:

-   -   a. a first construct comprising a first cDNA encoding E2F1         protein which is linked to Dp-1 protein and a first portion of a         luciferase gene at its C-terminus; and     -   b. a knockout of endogenous CDK4 and endogenous CDK6.

In another aspect, the present invention concerns a cell line comprising:

-   -   a. a first construct comprising a first cDNA encoding Dp-1         protein and a second cDNA encoding E2F1 protein which is linked         to a first portion of a luciferase gene at its C-terminus; and     -   b. a knockout of endogenous CDK4 and endogenous CDK6.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a schematic representation of PCR-mediated overlapping extension method that has been used for all of the linear DNA constructs.

FIG. 2 shows a schematic representation of CDK4/CDK6 pathway and NanoBit design.

FIG. 3A, FIG. 3B and FIG. 3C show the nucleotide sequences of RB1, E2F1, and DP1 fragments used in the NanoBit assay. FIG. 3D, FIG. 3E and FIG. 3F show amino acid sequences of corresponding Rb, E2F1 and Dp-1 fragments used in the NanoBit assay.

FIG. 4A shows combinations of Rb linked to NanoBit constructs and observed activity. FIG. 4B shows different combinations of E2F1 and Dp-1 linked to NanoBit and interaction activity with SB-Rb. FIG. 4C shows initial relative luciferase activity of CDK4 and CDK6 with and without specific CDK4/6 Inhibitor-Palbociclib.

FIG. 5A shows no endogenous contribution of CDK4 and CDK6 exposed to the CDK4/6 inhibitor Palbociclib. FIG. 5B shows relative luciferase activity of CDK4 and CDK6 for the stable CDK DKO cell line (CDK DKO #75) treated with CDK4/6 Inhibitor-Palbociclib.

FIG. 6 shows relative luciferase activity of CDK4 and CDK6 when treated with Palbociclib for 1, 2 and 24 hours.

FIG. 7A shows relative luciferase activity of CDK4 and CDK6 for stable single cell clones (E2F1-DP1-NanoBit construct integrated into genome) in clone numbers 11, 21, 39, and 49. FIG. 7B shows relative luciferase activity of CDK4 and CDK6 for stable single cell clones in clone numbers 24, 29, 31, and 30.

FIG. 8 shows relative luciferase activity of CDK4 and CDK6 untreated and treated with Palbociclib for stable clone cell line #11

FIG. 9A and FIG. 9B show optimization of the CDK4 and CDK6 assay by varying the amounts of Rb and CDK4/D1, respectively. FIG. 9C shows optimization by varying the ratio of CDK4/D1. FIG. 9D shows optimization by varying the amount of cells in the assay for CDK4 treated with Palbociclib.

FIG. 10A and FIG. 10B show the dose response curves for CDK4 and CDK6, respectively, with exposure to Palbociclib and Ribociclib over 2 hours.

FIG. 11A and FIG. 11B show relative luciferase activity of different CDK6 mutants exposed to Palbociclib. FIG. 11C and FIG. 11D show relative luciferase activity of different CDK4 mutants exposed to Palbociclib.

FIG. 12 shows relative luciferase activity of kinase dead CDK4 mutant with different amino acid substitutions at the same position exposed to Palbociclib.

FIG. 13A shows a dose response curve for potential drug resistant CDK4 mutant F93I. FIG. 13B shows dose response curve for another potential drug resistant CDK4 mutant T102K. FIG. 13C shows dose response curve for potential drug resistant CDK6 mutant T107K.

FIG. 14 shows a structural representation of the inhibitor binding channel of CDK6 and specific T107 amino acid residue shown inside the circle.

FIG. 15 shows a schematic representation of a PCR-mediated overlapping extension method used for all linear Rb constructs.

FIG. 16 shows a schematic representation of the NanoBit (Split Luciferase) design.

FIG. 17 shows the NanoBit constructs for Rb activity in the Rb assay.

FIG. 18A shows the validation of Rb activity assay by checking known Rb null mutants using the LB-Rb and E2F1-SB, DP1constructs. Absence of luciferase signal in the R661W and C706F mutants show loss of activity. FIG. 18B shows the validation of Rb activity assay by using in- and out-of frame deletion mutants and the LB-Rb and E2F1-SB, DP1 constructs. Absence of luciferase signal shows the loss of function of Rb protein.

FIG. 19A shows the validation of stable cell clones by using WT Rb and known Rb null mutant. FIG. 19B shows the validation of stable cell clones by using an out of frame Rb deletion mutant.

FIG. 20 shows optimization of Rb activity assay by checking different amounts of cells and the amount of transfected Rb linear construct.

FIG. 21 shows Rb activity using unknown mutants from the COSMIC database.

FIG. 22A shows Rb activity for two loss of function mutants from the COSMIC database. FIG. 22B shows confirmation of protein expression level of corresponding loss of function mutants (taken from COSMIC database) by western blot analysis.

FIG. 23 shows a schematic representation of the PCR-mediated overlapping extension method for the p16 assay.

FIG. 24 shows a schematic representation of the NanoBit (Split Luciferase) design for the p16 assay.

FIG. 25A shows inhibition of CDK4 by p16. FIG. 25B shows inhibition of CDK6 by p16.

FIG. 26A shows optimization of the p16 activity assay using different amounts of p16 where CDK4:Cyclin D1:SB-Rb are 25 ng:25 ng:30 ng. FIG. 26B shows optimization of the p16 activity assay using different cell amounts.

FIG. 27 shows validation of the p16 assay using different p16 mutants and CDK4.

FIG. 28 shows the validation of the p16 assay utilizing hyperactive CDK6 and CDK6 mutants and their binding to p16.

FIG. 29 shows the validation of the p16 assay using A36G p16 mutant binding to CDK4 and CDK6.

DETAILED DESCRIPTION OF THE INVENTION

The present invention can be better understood from the following description of preferred embodiments, taken in conjunction with the accompanying drawings. It should be apparent to those skilled in the art that the described embodiments of the present invention provided herein are merely exemplary and illustrative and not limiting.

Definitions

Various terms used in this specification shall have the definitions set out herein.

As used herein, the term “A,” “T,” “C,” and “G” refer to adenine, thymine, cytosine, and guanine as a nucleotide base, respectively.

As used herein, the terms “complement” or “complementation” refer to two halves of a protein coming into structural complex by binding to each other and producing a functional protein. “Complement” may also be used in reference to nucleic acids as in “reverse complement” to indicate an opposing strand of nucleic acids that resides in a particular sequence to bind to a polynucleotide.

As used herein, the term “CDK4” refers to the gene (SEQ. ID. NO: 1) which transcribes RNA that translates into the CDK4 protein.

As used herein, the term “CDK4” refers to cyclin-dependent kinase 4, also known as cell division protein kinase 4, which is an enzyme encoded by the CDK4 gene that phosphorylates Rb to advance cell cycle from GO or Gl to S phase. CDK4 is a family member of the cyclin dependent kinase family.

As used herein, the term “CDK6” refers to the gene (SEQ. ID. NO: 2) which transcribes RNA that translates into the CDK6 protein.

As used herein, the term “CDK6” refers to cyclin-dependent kinase 6, also known as cell division protein kinase 6, which is an enzyme encoded by the CDK6 gene that phosphorylates Rb to advance cell cycle from Gl to S phase. CDK6 is a family member of the cyclin dependent kinase family.

As used herein, the term “p16” refers to cyclin-dependent kinase inhibitor 2A, which is a tumor suppressor protein that is encoded by the CDKN2A gene that decelerates cell progression from the G1 phase to the S phase.

As used herein, the term “CDKN2A” refers to the gene (SEQ. ID. NO: 3) which transcribes RNA that translates into the p16 protein.

As used herein, the term “Rb” refers to retinoblastoma protein which is a tumor suppressor protein, one function of which is to prevent cell growth by inhibiting cell cycle progression.

As used herein, the term “RB1” refers to the gene (SEQ. ID. NO: 4) which transcribes RNA that translates into the Rb protein.

As used herein, the term “E2F” refers to the family of transcription factors that form a complex with pRb. For purposes of this application, the term E2F includes E2F1, E2F2 and E2F3a, more specifically, E2F1.

As used herein, the term “E2F1” refers to the gene (SEQ. ID. NO: 5) which transcribes RNA that translates into the E2F1 protein.

As used herein, the term “DP1” refers to transcription factor DP-1 which is a protein that dimerizes with E2F factors to bind DNA as homodimers or heterodimers.

As used herein, the term “TFDP1” refers to the gene (SEQ. ID. NO: 6) which transcribes RNA that translates into the Dp-1 protein.

As used herein, the term “Cyclin D1” refers to the protein that complex with CDK4 to promote the passage of the cell through G1 phase by inhibiting pRb, allowing E2F transcription factors to transcribe genes required for S phase to begin.

As used herein, the term “CCND1” refers to the gene (SEQ. ID. NO: 7) which transcribes RNA that translates into the Cyclin D1 protein.

As used herein the term “wild-type” or “WT” is a term of the art understood by skilled persons and means the typical form of an organism, strain, gene or characteristic as it occurs in nature as distinguished from mutant, variant, or modified forms.

As used herein the term “variant” means the exhibition of qualities that have a pattern that deviates from what occurs in nature or is distinct from the predominant form that occurs in nature. For the purposes of this application, the term “variant” can refer to non-dominant gene sequences, mutations or changes in resulting amino acid sequence. For purposes of this application, when the gene name is used in reference to a variant, it refers to a variant found within the DNA. When a protein name is used in reference to a variant, it refers to a DNA change that result in a “variant” amino acid change that may alter protein characteristics.

As used herein, the term “functional variant” refers to variants in a protein's amino acid sequence that acts functionally like WT protein.

As used herein, the term “vehicle” refers to a solvent of a compound. For purposes of this application the term “vehicle” is used as a negative control in the absence of a compound.

As used herein, the term “reverse transfection” refers to the process by which cells are seeded at the same time DNA is transfected into the cell. In the reverse transfection process nucleic acid and transfection reagent complex is assembled in the tissue culture plate and the cells are then seeded into the walls of the plate.

As used herein, the term “transiently transfected” refers to biological cells within which an expression vector encoding a foreign gene has been introduced into the cell in order to express the gene. Transiently transfected genes do not integrate the foreign gene into their genome and accordingly the foreign gene will not be replicated. Transiently transfected cells express the foreign gene for a finite period of time.

As used herein, the term “fold change” refers to a measure describing how much a quantity changes going from an initial value corresponding to WT protein activity compared to the mutant activity.

As used herein, the term “CRISPR” refers to Clustered regularly interspaced short palindromic repeats, which are sequences used by CRISPR associated proteins (Cas9) for the purpose of recognizing and cutting genetic elements of polynucleotides. CRISPR/Cas9 uses sgRNA as a recognition sequence for identifying where the Cas9 will bind and cut the genetic element. For the purposes of the examples of this specification, CRISPR/Cas9 and sgRNA were used for genomic modifications of CDK4 and CDK6 genes.

As used herein, the term “sgRNA” refers to single-guide RNA used as a recognition sequence for the CRISPR/Cas9 binding.

As used herein, the term “CDK inhibitor” means any compound or agent that inhibits the activity of one or more CDK proteins or CDK/cyclin kinase complexes. The compound or agent may inhibit CDK4/6 activity by direct or indirect interaction with a CDK protein or it may act to prevent expression of one or more CDK genes.

As used herein, the term “HEK293” refers to an immortalized cell line derived from human embryonic kidney cells.

As used herein, the term “cancer” refers to a malignant neoplastic disease. Most cancers are characterized by hyperproliferation of a cell population.

As used herein, the term “luciferase activity” refers to the use of a luciferase protein or reporter to assess the amount of luciferase complementation resulting from two-parts or halves of a luciferase protein coming into complex or luciferase protein generated by transcriptional activity in a cell under the control of a promoter of interest. The activity is measured by addition of a substrate that binds to the luciferase protein and emits a light signal that can be measured using a luminometer.

As used herein, the term “promoter” refers to a region of the DNA that facilitates the transcription of a particular gene.

As used herein, the terms “NanoBiT,” “Small BiT” and “Large BiT” refer to a split-luciferase complementation assay system consisting of two parts of a luciferase-based protein, where the Small BiT consists of 11 amino acids and the Large BiT consists of a 17.6 kDa protein. When the Small BiT and the Large BiT come into complex, the full luciferase is formed and can emit a light signal with the addition of a substrate.

As used herein, the terms “relative light units” or “RLU” refer to as the emitted light from a sample in a non-standardized scale as determined by a luminometer. The term “relative” indicates the units observed during the particular experiment and cannot be compared directly across experiments without standardization.

As used herein, the term “construct” refers to a plasmid or polynucleotide containing cDNA to encode for a given protein. As defined in the current application, the terms “first construct” and “second construct” refer to the complete plasmid and cDNA for encoding the expression of the protein linked to a portion of the luciferase gene. For the purposes of the current application, plasmids containing CRISPR/Cas9 and designed sgRNAs are also referred to as “constructs.” “Constructs” can also refer to polynucleotides having the necessary components to express a desired protein.

The present invention relates to methods for determining the effect of a CDK inhibitor on CDK variants, determining activity of Rb variants, determining activity of p16 variants, and the effect of p16 on CDK variants. In one aspect, the present invention provides highly sensitive methods for determining whether a CDK variant is sensitive to treatment with a CDK inhibitor (e.g. Palbociclib, Ribociclib, Abemaciclib, etc.).

Methods include providing a stable cell system containing cDNA constructs with signaling capability to measure the functional interaction between CDK variants and treatment with a CDK inhibitor, the functional interaction between CDK variants and p16, the activity of Rb variants, and the activity of p16 variants. The variants (CDK, p16 or Rb) may include one or more mutations in the CDK4, CDK6, RB1, and CDKN2A genes.

In one aspect of the invention, variants in the CDK4 and CDK6 genes are identified, by next generation sequencing (NGS), as potentially hyperactive and/or Palbociclib (Ribociclib, Abemaciclib) resistant.

In one aspect, the present invention provides a method to determine the effect of a CDK inhibitor on a CDK variant using a cell based assay. The present cell based assay involves the use of a first cDNA that encodes the protein of a CDK variant. The first cDNA can encode a protein of a CDK4 variant or a CDK6 variant. The first cDNA is transfected into a cell. The cell having been prepared to contain a knockout of endogenous CDK. The cell can have a knockout of endogenous CDK4, endogenous CDK6, or both. In certain embodiments, the cell contains a stably integrated first construct. The first construct can contain a second cDNA encoding E2F1 protein which is linked to a Dp-1 protein and a first portion of a luciferase gene, preferably at the C-terminus. A third cDNA encoding the protein for Cyclin D1 is transfected into the cell. A second construct containing a fourth cDNA encoding the Rb protein linked to a second portion of a luciferase gene, preferably at its N-terminus, is transfected into the cell. Upon transfection, the first cDNA construct produces a protein of E2F1 linked to a protein of Dp-1 which has a first portion of a luciferase protein in the cell. Similarly, the second cDNA construct produces a protein encoding the protein for Rb which has a second portion of a luciferase protein in the cell. Upon exposure of the cell to a CDK inhibitor, the interaction between the two protein products promote generation of light emission and therefore the CDK variant susceptibility to treatment with the CDK inhibitor.

In another aspect, the present invention provides a method to determine the activity of the RB gene variants. In certain embodiments, the present cell based assay involves the use of a cell which has a stably integrated first construct that contains a first cDNA encoding E2F1 protein which is linked to a first portion of a luciferase gene. When the mutation in the RB gene, identified by NGS, is in the N-terminal part, from 1-378 aa, the full length Rb activity assay will be used. In this embodiment, the first construct is linked to the first portion of a luciferase gene preferably at its C-terminus. In certain embodiments, when the mutation in the RB gene occurs between 379-928 aa, the Rb₃₇₉₋₉₂₈ activity assay is implemented and the first construct is linked to the first portion of a luciferase gene preferably at its N-terminus. In certain embodiments, the first construct also contains a second cDNA encoding Dp-1 protein. In certain embodiments, a linear third cDNA encoding a Rb variant from a patient is prepared. Combinations of genetic modifications are also within the scope of the invention. In another embodiment, the third cDNA is linked to a second portion of a luciferase gene, preferably at its C-terminus to form a second construct. In another embodiment, the second construct transfected into the cell containing the stably integrated first construct. When the first construct and the second construct are in close proximity, a complex is formed that emits light. The protein product generated from the first construct interacts with the protein product generated from the second construct to produce a light emission upon the addition of a luciferase substrate. The present assay takes advantage of the interaction between E2F1-Dp-1 protein and the Rb variant protein. When the Rb and E2F1-Dp-1 proteins interact, a negative feedback system is created wherein light emission indicates a functional Rb variant. When Rb does not interact with E2F1-Dp-1 in the present cell assay, no light is produced, indicating a mutation in the Rb variant preventing phosphorylation of Rb by Cyclin D-CDK4/6. Accordingly, the Rb variant is determined as active when there is an increase in light emission relative to a control cell assay.

In another aspect, the present invention provides a method for determining the activity of p16 variant in a cell based assay. In certain embodiments, the assay cells have a knockout of endogenous CDK4, endogenous CDK6, or both endogenous CDK4 and endogenous CDK6. In certain embodiments, the cells have a first construct containing a first cDNA encoding E2F1 protein linked to Dp-1 protein and a portion of a luciferase gene, preferably at its C-terminus, (e.g. SEQ. ID. NO: 215) stably integrated into the cell. In another embodiment, a second construct comprising a second cDNA encoding Rb protein linked to a second portion of a luciferase gene, preferably at its N-terminus, (e.g., SEQ. ID. NO: 214) is prepared as part of a transfection complex. In another embodiment, a third cDNA encoding Cyclin D1 (e.g., SEQ. ID. NO: 7) and a forth cDNA encoding a CDK protein is prepared as part of the transfection complex. In certain embodiments, the forth cDNA can encode CDK4 protein or CDK6 protein. In another embodiment, a fifth cDNA of a p16 variant is prepared as part of the transfection complex. In some embodiments, cDNA can be plasmid. In other embodiments, cDNA can be linear. In some embodiments, the cDNA of a p16 variant is obtained from a mammalian patient. In certain embodiments, the transfection complex is transfected into the cell. In some embodiments, the transfection of the transfection complex is transient. The present assay takes advantage of the known interaction between p16 and CDK4/6. When the p16 variant is active, inhibition of CDK4/6 prevents phosphorylation of Rb. The interaction between the two protein products of the first construct and the second construct promote the generation of light emission and therefore allows the indirect measurement of p16 activity.

In another aspect, the present invention provides a method for determining the sensitivity of a CDK4 variant or a CDK6 variant to p16 in a cell. In certain embodiments, the cells have a knockout of endogenous CDK4 and endogenous CDK6. In certain embodiments, the cells have a first construct containing a first cDNA encoding E2F1 protein linked to Dp-1 protein. In a preferred embodiment E2F1 protein is linked to a first portion of a luciferase gene at its C-terminus. In another preferred embodiment, the first construct is stably integrated into the cells. In another embodiment, a second cDNA of a CDK4 variant or a CDK6 variant from a patient is prepared. In another embodiment, a third cDNA encoding Rb protein linked to a second portion of a luciferase gene, preferably at its N-terminus, is prepared. In another embodiment, a fourth cDNA encoding Cyclin D1 protein is prepared. In another embodiment a fifth cDNA of wild-type p16 is prepared. In another embodiment, a transfection complex containing the second construct, the third cDNA, the fourth cDNA and the fifth cDNA is prepared. In a preferred embodiment, the transfection complex is transiently transfected into the cell. The present assay takes advantage of the role of p16 as a natural inhibitor of CDK4/6. When p16 inhibits CDK4/6, Rb interacts with the E2F1 and Dp-1 proteins. In the present assay, the interaction between the two protein products of the first construct and the second construct promote the generation of light emission and therefore allows the indirect measurement of the CDK4 or CDK6 variant sensitivity to wild-type p16. After transfection, the protein products generated from the first and second construct interact to produce a light emission upon addition of a luciferase substrate. The constructs may include other components desirable for adequate expression of the desired protein(s).

In certain embodiments the cDNA encoding for CDK4/6 contains variants that distinguish CDK4/6 from wild-type CDK4/6. In certain embodiments the cDNA encoding for Rb contains variants that distinguish Rb from wild-type Rb. In certain embodiments the cDNA encoding for p16 contains variants that distinguish p16 from wild-type p16.

The exact sequence and size of the first and second portions of the luciferase gene in the first and second constructs may vary provided that when the two portions of the luciferase gene are expressed in an assay cell, the protein products interact to generate a measurable light emission or light signal upon addition of a luciferase substrate. An example of a suitable two-subunit system for detection of protein interaction utilizing luminescent enzymes is NanoLuc® Binary Technology (NanoBiT).

The present assay can be used in personalized medicine. When genome information is obtained relating to CDK4 or CDK6 gene sequences, one skilled in the art can prepare a cDNA based on the CDK4 or CDK6 gene sequence information. The generated cDNA may be a unique cDNA equivalent to a variant or wild-type sequence of the CDK4 or CDK6 gene of an individual. When genome information is obtained relating to RB sequences, one skilled in the art can prepare a cDNA based on the RB gene sequence information. The generated cDNA may be a unique cDNA equivalent to a variant or wild-type sequence of the RB gene of an individual. When genome information is obtained relating to CDKN2A sequences, one skilled in the art can prepare a cDNA based on the CDKN2A gene sequence information. The generated cDNA may be a unique cDNA equivalent to a variant or wild-type sequence of the CDKN2A gene of an individual. In one aspect, the present invention provides an assay to test patient variants in the CDK4 or CDK6 gene, as identified by next generation sequencing (NGS), thus determining potentially hyperactive and/or inhibitor resistant mutations. In another aspect, the present invention provides an assay to test patient variants in the RB gene, as identified by NGS, thus determining potentially functional or loss of function mutations. In yet another aspect, the present invention provides an assay to test patient variants in the CDKN2A gene, as identified by NGS, thus determining potentially active or loss of function mutations. One advantage of the present assay is to transfect the generated cDNA into an assay cell containing a cDNA encoding E2F1 protein linked to Dp-1 protein and having a knockout of endogenous CDK. A second construct containing another cDNA encoding Rb protein is transfected into the cell. The first cDNA and the second cDNA each link at its C-terminus and N-terminus, respectively, to a separate portion of a luciferase gene. When two portions of the luciferase gene linked to different proteins interact, a signal is created which serves as an indirect measurement of the activity of CDK protein encoded by the mutant or wild-type CDK4 or CDK6.

In certain embodiments, the cDNA may be transiently transfected into the cell. In certain embodiments the cDNA may be stably transfected into the cell. In certain embodiments, cDNAs may be added to the cell by a combination of transient transfection and stable transfection. In one embodiment the cDNA of CDK4/6 or the CDK4/6 variant is transiently transfected. In one embodiment the cDNA of RB or the RB variant is transiently transfected. In another embodiment the cDNA of CDKN2A or the CDKN2A variant is transiently transfected.

In another aspect, the present invention provides a cell line having a double knockout of endogenous CDK4 and endogenous CDK6. In certain embodiments, the cells contain a first construct having a cDNA encoding E2F1 protein linked to Dp-1 protein and a first portion of a luciferase gene, preferably at its C-terminus. In another embodiment, the first construct contains a cDNA encoding E2F1 protein and a first portion of a luciferase gene at its C-terminus.

In certain embodiments, the cell can be a mammalian cell. Preferably, the cell can be a human cell. Examples of cells include, but are not limited to, a breast cell, a kidney cell, a liver cell, a leukocyte cell, a brain cell, an endometrial cell, a colorectal cell, a renal cell, and the like. In certain embodiments the cell is a tumor cell. In certain embodiments, the cell has already been transfected to contain a first cDNA. In certain embodiments, the cell has already been transfected to contain a first cDNA and a second cDNA. In certain embodiments of the invention, the cells have genomic modifications of CDK4, CDK6, or CDK4 and CDK6, which may result in a knock down or a knockout of endogenous CDK4 and/or CDK6 protein. Combinations of genetic modifications are also within the scope of the invention. In certain embodiments, the transfected cells contain a first cDNA construct encoding E2F1 linked to a Dp-1 and a first portion of a luciferase gene (e.g., SEQ. ID. NO: 215) and a second cDNA encoding Rb linked to a second portion of a luciferase gene (e.g., SEQ. ID. NO: 216). In another embodiment, the transfected cDNA is linear or plasmid.

The parent cells of the cell lines of the invention are mammalian cells, such as rat, mouse, hamster, monkey, and human cells. Specific examples of parent cell lines of the invention include HEK293 (human embryo kidney), MCF-7 (human breast cancer), HeLa (human cervix epithelial carcinoma), HT29 (human colon adenocarcinoma grade II), A431 (human squamous carcinoma), IMR 32 (human neuroblastoma), K562 (human chronic myelogenous leukemia), U937 (human histiocytic lymphoma), MDA-MB-231 (Human breast adenocarcinoma), SK-N-BE(2) (human neuroblastoma), SH-SY5Y (human neuroblastoma), HL60 (human promyelocytic leukemia), CHO (Chinese hamster ovary), COS-7 (African green monkey kidney, SV40 transformed), S49 (mouse lymphoma), Ltk (mouse C34/connective tissue), NG108-15 (mouse neuroblastoma and Rat glioma hybrid), B35 (rat neuroblastoma), B50 (rat nervous tissue), B104 (rat nervous tissue), C6 (rat glial tumor), Jurkat (human leukemic T cell lymphoblast), BEM (baby Syrian hamster kidney), Neuro-2a (mouse albino neuroblastoma), NIH/3T3 (mouse embryo fibroblast), A549 (human adenocarcinoma alveolar epithelial), Be2C (human neuroblastoma), SW480 (human colon adenocarcinoma), Caco2 (human epithelial colorectal adenocarcinoma), THP1 (human acute monocyte leukemia), IMR90 (human fetal lung fibroblast), HT1080 (human fibrosarcoma), LnCap (human prostate adenocarcinoma), HepG2 (human liver carcinoma) PC12 (rat adrenal gland phaeochromocytoma), or SK-BR-3 (human breast cancer) cells. In another embodiment, the parent cells are U20S (human osteosarcoma) cells. In another embodiment, the parent cells are NCI-60 (human tumor) cell lines, such as, A549, EKVX, T47D, or HT29.

In certain embodiments, the CDK4/6 variant contains one mutation. In certain embodiments, the CDK4/6 variant may contain two mutations. In certain embodiments, the CDK4/6 variant may contain three mutations. In certain embodiments the CDK4/6 variant may contain four or more mutations. Similarly, the RB or CDKN2A variant can contain at least one mutation. For example, the RB variant can contain one, two, three, four or more mutations. The CDKN2A variant can contain one, two, three, four or more mutations. Functional variants of CDK4/6, Rb and p16 are those variants that are effective in performing the methods of the invention. These variants can be mutations or polymorphisms. Functional variants can be truncations, such as truncations of 30 amino acid residues or less, or 25 amino acid residues or less, or 20 amino acid residues or less. Examples of functional variants are shown in Table 11 and FIG. 19B.

In certain embodiments, the luminescence or light signal is produced by a structural complementation reporter designed for protein to protein interactions such as NanoLuc® Binary Technology (NanoBiT). In certain embodiments, the luminescence signal is produced by Firefly or Renilla Luciferase. In certain embodiments, the protein to protein interactions are measured by fluorescence signaling systems such as Fluorescence Resonance Energy Transfer (FRET) or by a combination luminescence signal such as Bioluminescence Resonance Energy Transfer (BRET).

In another aspect, the present invention provides a method to determine whether a particular CDK4/6 variant is sensitive to treatment with CDK inhibitors. The method involves preparing a first cDNA encoding a CDK variant of interest followed by transfecting the first cDNA into a cell. The cell is also transfected with first construct containing a second cDNA encoding E2F1 protein linked to Dp-1 protein. A third cDNA encoding Cyclin D1 is also transfected into the cell with the second construct which contains a fourth cDNA encoding Rb protein. The second cDNA is linked at its C-terminus to a first portion of a luciferase gene and the fourth cDNA is linked at its N-terminus to a second portion of a luciferase gene. When the cell is exposed to a CDK inhibitor, CDK4/6 is inactivated, which allows the E2F1 protein linked to the Dp-1 protein to interact with the Rb protein to form the complex which results in a light signal.

In certain embodiments, the transfected cells (i.e., the cells having the cDNA encoding a CDK4/6 variant, a first construct containing cDNA encoding E2F1 linked to Dp-1 protein and a first portion of a luciferase gene, and a second construct containing cDNA encoding Rb linked to a second portion of a luciferase gene) are then exposed to Palbociclib, Ribociclib, or Abemaciclib. A convenient approach to measure the cells response to Palbociclib is to obtain concentration dependent curves. By way of example, Palbociclib can be used from 10 nM to 50 nM to 500 nM. The sensitivity of the CDK4/6 variant toward Palbociclib, Ribociclib, or Abemaciclib can be conveniently measured by an increase in light emission as compared to a negative control (i.e., a vehicle without CDK inhibitor).

In certain embodiments, the cell is transfected with a cDNA encoding CDK4/6. The cDNA can be conveniently prepared using standard methodologies known to one skilled in the art. In certain embodiments, the cDNA can be CDK4/6 wild-type. In certain embodiments the cDNA can be a CDK4/6 variant. In further embodiments, the CDK4/6 variants can contain one or more mutations different from the CDK4/6 wild-type.

In certain embodiments, the present assay can also be used to test if a particular compound has an inhibitory effect toward CDK4/6 protein. The cell system containing the CDK4/6 variant, a construct containing a cDNA encoding E2F1 linked to Dp-1 and a first portion of a luciferase gene, and a construct containing a cDNA encoding Rb linked to a second portion of a luciferase gene, are exposed to a CDK4/6 inhibitor. The sensitivity of the CDK4/6 variant to treatment with the CDK4/6 inhibitor can be measured by an increase in light emission as compared to a negative control.

In certain embodiments, the cells have a knockout or knock down of endogenous CDK4/6. In certain embodiments, the knock down is a genomic modification of at least a portion of the CDK genes that results in a loss of protein expression of CDK4/6, respectively. In certain embodiments, the genomic modification is performed using CRISPR/Cas9 technology. In certain embodiments, the genomic modification is performed using TALENs or recombination technology.

In certain embodiments, the cells have a knock down or knockout of endogenous CDK4/6. In certain embodiments, the knock down or knockout of CDK4/6 is completed in cells that have a genomic modification of at least a portion of the CDKN1A gene. In certain embodiments, the knock down or knockout of CDK4/6 is completed by genomic modification of CDK4/6 using CRISPR/Cas9 technology. In certain embodiments, the genomic modification of CDK4/6 is performed using TALENs or recombination technology. In certain embodiments, the knock down or knockout of CDK4/6 protein may be accomplished through siRNA treatment.

In certain embodiments, the present assay may be used to determine whether variants in a patient CDK4/6 gene would create a variant CDK4/6 that will respond to a specific CDK4/6 inhibitor. The method involves preparing a cDNA equivalent to a CDK4/6 variant from a patient followed by transfecting the cDNA into a cell. The cell has undergone a genomic modification to the CDK4/6 gene, resulting in CDK4/6 knock down or preferably knockout. The cell has been transfected with a first construct containing a cDNA encoding E2F1 protein linked to Dp-1 protein as well as a second construct containing a cDNA encoding Rb protein. The first cDNA is linked at its C-terminus to a first portion of a luciferase gene and the second cDNA is linked at its N-terminus to a second portion of a luciferase gene. When CDK4/6 is inactivated, the protein products of the two cDNAs interact to form a complex and produce a light signal.

In certain embodiments, the present assay may be used to screen new CDK4/6 inhibitor compounds to determine efficacy in the treatment of cancer. CDK4/6 inhibitors that are currently part of cancer treatment studies include Palbociclib, Ribociclib, and Abemaciclib. Depending on the compound to be utilized in the assay, suitable vehicles include DMSO, DMF, water, aliphatic alcohols, and mixtures thereof. In certain embodiments, the present assay may be used to identify new chemical compounds to assess their abilities to inhibit CDK4/6.

The assays of the invention are carried out under culture conditions effective for protein expression from cells. The assays are performed in a vessel capable of holding the cells and reagents and not interfering with assay results. In some embodiments the plates are surface treated to facilitate adherence of the assay cells to the wells of the plate, such treatment is commonly referred to as “tissue culture treated”. The surface treatment is typically an oxygen plasma discharge that renders the surface of the wells more hydrophilic. In some embodiments the assays are miniaturized and use multi-well plates known in the art. In certain embodiments, the present assay can be conveniently performed in a 96 well plate, but can also be adopted for high-throughput 384 well plates or 1536 well plates. In some embodiments dispensing the cells and/or reagents for the assays into the wells of the plates is automated. In some embodiments the cells and/or reagents are dispensed continuously at a high speed. In one embodiment an acoustic liquid dispenser is used to dispense the reagents.

The following examples are provided to further illustrate various preferred embodiments and techniques of the invention. It should be understood, however, that these examples do not limit the scope of the invention described in the claims. Many variations and modifications are intended to be encompassed within the spirit and scope of the invention.

EXAMPLES Example 1 Next-Generation Sequencing to Interrogate Mutation of Tumor

Since genetic alterations are very common cause in different types of cancer, knowing the gene mutations and drug resistance would be beneficial in cancer therapy. To survey the mutation status of CDK4 and CDK6 genes, whole exome sequencing was performed. Genomic DNA was extracted and used to prepare library for next-generation sequencing. The identified mutations, which caused change in amino acid sequence, were picked to examine its functional effect on the genes in our proprietary cell-based assay described below. The patient gene carrying the identified mutation is constructed using polymerase chain reaction (PCR) mediated overlapping extension in a format of linear expression cassette.

Example 2 Construction of Linear Expression Cassette of Human CDK4/6

In order to study the effect of unknown mutations in human CDK4 and CKD6 genes, we decided to generate linear expression cassette, containing CMV promoter that controls CDK4/6 expression, coding sequence of CDK4/6 followed by terminator and polyadenylation signal. To do so, overlapping extension PCR was employed to construct the linear expression cassette using expression plasmids of human CDK4/6 as PCR template. Employing this method, the construction of linear expression cassette takes around 4-8 hours. However, the traditional cloning method to generate expression plasmid takes around 2-4 days. Therefore, making patient gene in linear expression cassette format is crucial for a clinical diagnostic test because of its quick turn-around time.

Example 3 Construction of Expression Plasmids of Human CDK4, CDK6 and CCND1

cDNA plasmids encoding human CDK4, CDK6, and CCND1 genes were purchased (Dharmacon). The coding sequences of the previously mentioned genes were amplified by PCR. NheI and NotI/XhoI restriction enzyme sites were inserted into forward and reverse primers respectively for purpose of cloning (Table 1). PCR products containing the coding sequences of human CDK4, CDK6 and CCND1 were sub-cloned into the pcDNA3.1 (+) using NheI and (NotI)/XhoI restriction enzymes. The nucleotide sequences of all genes were verified by DNA sequencing. These human CDK4 and CDK6 expression plasmids were used as PCR templates to construct linear expression cassettes of wild-type (“WT”) or mutated forms of CDK4 and CDK6.

TABLE 1 Primers used for expression plasmids CDK4 NheI F TG GCT AGC C GCC ACC ATG GCT ACC TCT CGA TAT GAG [SEQ. ID. NO: 8] CDK4 NotI R CGA GC GGCCGC TCA CTC CGG ATT ACC TTC ATC [SEQ. ID. NO: 9] CDK6 NheI F TG GCT AGC C GCC ACC ATG GAG AAG GAC GGC CTG TGC [SEQ. ID. NO: 10] CDK6 XhoI R GA CTC GAG TCA GGC TGT ATT CAG CTC CGA [SEQ. ID. NO: 11] CCND1 NheI F ATTAGCTAGCGCCGCCACCATGGAACACCAGCTCCT [SEQ. ID. NO: 12] CCND1 XhoI R ATACTCGAGTCAGATGTCCACGTCCCGCAC [SEQ. ID. NO: 13]

Generation of Linear Expression Cassette of WT and Mutated CDK4 and CDK6

A linear expression cassette of human WT CDK4 and CDK6 was generated by UF-CMV forward and BGH-UR reverse primers. The amplified products were gel-purified. The DNA concentration was quantitated by the optical density at 260 nm using Nanodrop.

A linear expression cassette of mutated CDK4 or CDK6 was generated by PCR mediated overlapping extension method. A pair of forward and reverse primers containing the targeted mutations was designed. The mutated codon was located in the middle of a primer flanked by 18-21 nucleotides on each side. Two PCRs (named as PCR #1 and PCR #2 in FIG. 1 ) were performed using UF-CMV forward and mutated reverse primers, or mutated forward and BGH-UR primers. The PCR products were cleaned up by ExoSAP-IT® (Affymetrix) to remove unconsumed dNTPs and primers. The treated PCR products were mixed together followed by dilution with water. A second round of PCR was performed using the diluted PCR mixture, and the UF and UR primers (FIG. 1 ). The amplified products were gel-purified. The DNA concentration was quantitated by the optical density at 260 nm using Nanodrop. The targeted mutations were incorporated in the CDK4 or CDK6 genes during the PCR mediated overlapping extension method. The introduced mutations were confirmed by the DNA sequencing.

Example 4 Transfection Method

HEK293 cells are specific cell line originally derived from human embryonic kidney cells grown in tissue culture. HEK293 cells have been widely used in cell biology research for many years because of their reliable growth and propensity for transfection. In general, there are two major types of transfection, forward and reverse.

A reverse transfection protocol was performed whereby freshly passaged cells were added to transfection complexes to reduce hands-on time for the end user. During this process, cells were not adhered to the plate surface by the time they interacted with the transfection complexes.

Example 5 Interacting Partners for Our NanoBit Assay

An assay that could measure the interaction between Rb, E2F1 and Dp-1 was developed, since Dp-1 forms a heterodimer with E2F1 and this interaction is important for Rb/E2F1 binding. When two proteins (Rb and E2F1) are in close proximity or in complex, a light signal was generated. For the purposes of the current assay, split-luciferase complementation was used to measure the interaction between Rb and E2F1, which was used as a surrogate measure of CDK4/6 activity and the ability of CDK4/6 to respond to a CDK4 or CDK6 inhibitor (for example, Palbociclib, Ribociclib, or Abemaciclib). The NanoBiT assay system by Promega (Madison, Wis.; Dixon et al., 2015, ACS ChemBiol) was used in the split luciferase complementation design.

FIG. 2 depicts a design of a signal system to measure CDK4/6 activity. Under basal conditions inside the cell, Rb was active and interacted with an E2F1/Dp-1 heterodimer. However, in the presence of the CDK4 or CDK6, Rb is phosphorylated and released from the interacting complex. In the presence of a CDK4 or CDK6 inhibitor (for example, Palbociclib, Ribociclib, or Abemaciclib), CDK4/6 was no longer available, thus promoting Rb/E2F1-Dp-1 complex formation (FIG. 2 ). For this assay design, cDNAs of Rb linked to different parts of the luciferase protein were created, either termed as the “Small BiT” (SB), or “Large BiT” (LB) and E2F1-Dp-1 was linked to the different portion of the luciferase protein. When Rb and E2F1/Dp-1 bind, the NanoBiT parts of the luciferase complement each other, and they emitted a light signal when the luciferase (NanoGlo) substrate was added.

PCR was performed and the ligated cDNAs fragments of RB, E2F1, and DP1 were generated, according to methods known in the art, into NanoBiT designed vectors MCS-1, MCS-2, MCS-3, and MCS-4, respectively (available from Promega). Oligonucleotide primers designed for subcloning are indicated in Table 2 and Rb, E2F1, and Dp-1 DNA and amino acids' fragments used in NanoBit assay are shown in FIG. 3 .

Example 6 Finding the Best Combination of Partners for NanoBit Assay

Using the above-described assay, HEK293 cells were transiently transfected with different combinations of SB-Rb or LB-Rb and E2F1-Dp-1/LB or E2F1-Dp-1/SB components containing C-terminal and N-terminal constructs (FIG. 4A). The generated constructs were tested for the high luciferase signal and the SB-Rb with E2F1 and Dp-1-LB at C-terminus or N-terminus (FIG. 4B) were selected for further use. Relative intensities are represented as relative luminescence units (RLU) (FIG. 3 ). Data represents a sample experiment where each condition was performed in triplicate and represent mean+SD. According to the data the higher luciferase activity is observed for SB-Rb and E2F1-LB, Dp-1 constructs.

Example 7 Overexpression of CDK4/6 Treated with Palbociclib in NanoBit Approach

The selected SB-Rb, E2F1-LB, and Dp-1-LB complex was tested for specific CDK4 or CDK6 activity using the inhibitor Palbociclib (FIG. 4C). When CDK4 or CDK6 was added, decreased activity was observed as Rb is phosphorylated and there is no Rb/E2F1-Dp-1 interaction. With treatment of an inhibitor (for example, Palbociclib, Ribociclib, or Abemaciclib), an increased luminescence was observed, which was consistent with a decrease in CDK activity resulting in an increased interaction between SB-Rb and E2F1-Dp1-LB.

The “fold change” based on the fraction of luminescence activity observed in cells treated with Palbociclib was compared to that of the vehicle treated. To examine the ability of the split luciferase to properly assay CDK4/6 activity, HEK293 cells were transfected with CDK4 (CDK6) and CyclinD1 and then tested for the dependence of CDK activity with a 2 hour (“h” or “hr”) treatment with Palbociclib (500 nM). An increase in signal with Palbociclib was interpreted to coincide with the ability to evaluate CDK4/6 activity by the designed assay.

Structural biology data of co-crystallizing RbC, E2F1, and Dp-1 suggested relatively close proximity of the N-terminus of RbC with C-terminus of E2F1 and Dp-1 (Rubin et. al, Cell, 2005).

Optimized cDNAs for the assay with the SB to be N-terminally linked to RB (A) and the LB to be C-terminally linked to E2F1 (B), or the LB to be N-terminally linked to Dp-1 (C) are indicated in FIG. 3 . The underlined portion is the SB or LB of the sequence. The remainder of the cDNA sequence is the cDNA provided by Origene for the expression of the designed protein. All sequences were confirmed by Sanger Sequencing. Based on the cDNA sequences, the SB-RB (D), E2F1-LB (E), and LB-DP1 (F) were created with the indicated nucleic acid sequences, when the cDNAs were expressed in mammalian cells.

TABLE 2 Primers designed for subcloning RB, E2F1 and DP1 cDNA constructs into NanoBiT vectors. Target/Purpose Forward Primer Reverse Primer E2F1-LB, E2F1-SB CT AAGCTT GCC ACC C AGA ATT CCC CTC CTC into MCS-1, MCS-2 ATG CTC GAC TAC CAC AGG GCA CAG GAA AAC using Hind III and EcoRI TTC GGC CT [SEQ. ID. NO: 15] [SEQ. ID. NO: 14] RB-LB, RB-SB into MCS-1 CT AAGCTT GCC ACC C AGA ATT CCC TTT CTC MCS-2 ATG TAT GCT TCC ACC TTC CTT GTT TGA GGT using Hind III and EcoRI AGG CCC CCT ATC CAT [SEQ. ID. NO: 16] [SEQ. ID. NO: 17] DP1-LB, DP1-SB CT AAGCTT GCC ACC C AGA ATT CCC TGC CGT into MCS-1, MCS-2 ATG GCT CAG GAA TGT CGT GAT GAA CAC GCC using Hind III and EcoRI CAG AAC TTA GAG [SEQ. ID. NO: 19] [SEQ. ID. NO: 18] LB-E2F1, SB-E2F1 into MCS- AGG AAT TCA CTC GAC AC TCT AGA TTA CTC 3, TAC CAC TTC GGC CT CTC AGG GCA CAG GAA MCS-4 using EcoRI and XbaI [SEQ. ID. NO: 20] AAC [SEQ. ID. NO: 21] LB-RB, SB-RB AGG AAT TCA TAT GCT AC TCT AGA TTA TTT into MCS-3, MCS-4 TCC ACC AGG CCC CCT CTC TTC CTT GTT TGA using EcoRI and XbaI [SEQ. ID. NO: 22] GGT ATC CAT [SEQ. ID. NO: 23] LB-DP1, SB-DP1 AGG AAT TCA GCT CAG AC TCT AGA TTA TGC into MCS-3, MCS-4 GAA TGT CAG AAC TTA CGT CGT GAT GAA CAC using EcoRI and XbaI GAG GCC [SEQ. ID. NO: 24] [SEQ. ID. NO: 25]

Example 8 CRISPR Method to Eliminate Endogenous CDK4 and CDK6

CRISPR technology was used to genomically modify the CDK4 and CDK6 genes and remove their expression even though there is no endogenous contribution of CDK4 and CDK6 in our assay. Primers that were used for screening CDK DKO clones are presented in Table 3. Data is shown in FIG. 5 .

TABLE 3 CRISPR screening primers Target Forward Primer Reverse Primer CDK4 5′-ATGCAAGGCATGTGTCATGT GCAAGAGTTCAAGACCA [SEQ. ID. NO: 26] GCC 5′-TTGTTGCTGCAGGCTCATAC [SEQ. ID. NO: 28] [SEQ. ID. NO: 27] CDK6 5′-TATGGGAAGGTGTTCAAGGC CTGTGCCTGGATTACCC [SEQ. ID. NO: 29] ACT 5′-TGCACAGTGTCACGAACAGA [SEQ. ID. NO: 31] [[SEQ. ID. NO: 30]

Example 9 NanoBit Assay and Different Time Treatment with CDK4/6 Inhibitor

The assay was further optimized by examining the time of treatment required to see the effect indicated by treating SB-Rb/LB-Dp-1/E2F1-LB transfected HEK293/CDK DKO cells with Palbociclib from 1-24 hours (FIG. 6 ). The increase in fold-change, indicated by the numbers above the bars, was the highest at 24 hr of treatment, and less for 1 or 2 hr of treatment. Therefore, the SB-Rb/LB-Dp-1/E2F1-LB assay performs best within 24 hr of treatment.

Example 10 Selection of Stable Cell Clones Carrying E2F1-Dp-1-LB

Within the provided assay design, stable cell lines were produced using the HEK293 CDK DKO cell parent line expressing E2F1-Dp-1/LB linked together (there is GGSG between them). After selection and screening for positive clones using a SB-Rb-mediated increase in signal, WT CDK4 or WT CDK6 was transfected into independent stable single-cell clones. All of the single-cell clones generated containing the E2F1-Dp-1/LB responded to Palbociclib, Ribociclib, or Abemaciclib with an increase in signal, as previously observed with over-expression of WT CDK4 or WT CDK6 (FIG. 7 ). Cell line #11 had the best response and was chosen for all future use in assay development (FIG. 8 ).

Example 11 Using Stable Cell Line #11 and Assay Optimization

Using stable cell line #11 the assay was optimized for 384 well format plate by examining different Rb amounts (FIG. 9A), CDK4/D1 amounts (FIG. 9B), CDK4/D1 ratios (FIG. 9C), and cell amounts (FIG. 9D). The increase in fold-change, indicated by the numbers above the bars, was the highest at the following conditions: using 30 ng of Rb, 25 ng of CDK4 and CyclinD1 for CDK4 assay, and 35 ng of CDK6 and CyclinD1 for CDK6 assay, and 0.2×10⁶ cells/ml and 0.3×10⁶ cells/ml respectively.

Example 12 Dose Response Curves for WT CDK4 and CDK6

Based on the effectiveness of the assay created, complete concentration curves for Palbociclib and Ribociclib were measured. HEK293/CDK DKO expressing E2F1-Dp-1-LB cells were transiently transfected with SB-Rb, CyclinD1, and CDK4 or CDK6, as previously indicated, and then treated for 24h with Palbociclib (FIG. 10A) or Ribociclib (FIG. 10B) at a range of concentrations covering 8 logs. Based on the results, EC50s were obtained for Palbociclib at ˜22.8 nM and for Ribociclib at ˜62.5 M for CDK4 and at ˜17.3 nM and at ˜90.5 nM for CDK6 respectively, using GraphPad Prism software (FIG. 10 ).

These values are comparable to a literature reported IC50 for Palbociclib in inhibiting phosphorylation of Rb (see Aleshin&Finn, 2016, BCR).

Example 13 Assay Validation by Using Known Kinase Dead and Unknown COSMIC Mutations

To examine the ability of the assay to detect variants in CDK4 or CDK6 that affect function, kinase dead mutants and COSMIC (Catalogue Of Somatic Mutations in cancer) unknown mutants were created. For comparison, hyperactive CDK4 or CDK6 mutants known to be hyperactive due to less binding to natural inhibitor p16 were also created. The mutations in CDK4 or CDK6 were created by site-directed mutagenesis. The primers are indicated in Table 4. WT or mutated CDK4 or CDK6 along with the CyclinD1 and SB-Rb were co-transfected, under similar conditions as previously indicated (see FIG. 9 ). Over-expression of WT CDK4 or CDK6 exhibited the previously observed increase in Palbociclib-induced signal (FIG. 11 ). In addition, the hyperactive mutants R31C and R24C for CDK6 and CDK4, respectively, presented with a little bit lower basal signal than WT but not as close to zero as expected for the hyperactive mutant in the absence of drug treatment, which was indicative of greater phosphorylation of Rb, reducing the interaction with E2F1. However, these hyperactive mutants were considered hyperactive due to less binding to natural inhibitor p16, and yielding a greater fold-change in response to Palbociclib (as expected; see Tsao et al., 1998). Therefore the CDK4/CDK6 assay is capable of determining both CDK4 and CDK6 mutants' responsiveness to Palbociclib, Ribociclib, or Abemaciclib and the relative activity level of CDK4/CDK6 mutants.

Example 14 Assay Validation by Using Different Amino Acid Substitutions of the Kinase Dead Mutant at the D158 Residue

To examine the specificity of the assay, particular CDK4 kinase dead mutants were created. Modifications to D158 were made by changing aspartate to nonpolar alanine (D158A) or positively charged arginine (D158R). D158D, with one nucleotide substitution that did not change the amino acid, was used as a control. The mutations in CDK4 were created by site-directed mutagenesis. The primers are indicated in Table 4. WT or mutated CDK4 along with the CyclinD1 and SB-Rb was co-transfected into the #11 cell line, under the same conditions as previously indicated. Over-expression of WT CDK4 exhibited a decrease in signal (FIG. 12 ). Kinase dead mutants have the high signal due to inability to phosphorylate Rb. The D158D mutant with one nucleotide substitution showed the same activity as a WT.

TABLE 4A Primers for site-directed mutagenesis of CDK4 CDK4 mutant Forward primer Reverse primer K22M TATGGGACAGTGTACATGGCCCG GTGGGGATCACGGGCCATGTACA TGATCCCCAC CTGTCCCATA [SEQ. ID. NO: 32] [SEQ. ID. NO: 33] K22A GCCTATGGGACAGTGTACGCGGC ACTGTGGGGATCACGGGCCGCGT CCGTGATCCCCACAGT ACACTGTCCCATAGGC [SEQ. ID. NO: 34] [SEQ. ID. NO: 35] R24C ACAGTGTACAAGGCCTGTGATCC GCCACTGTGGGGATCACAGGCCTT CCACAGTGGC GTACACTGT [SEQ. ID. NO: 36] [SEQ. ID. NO: 37] R24A GCCTATGGGACAGTGTACAAGGC TATGGGACAGTGTACATGGCCCGT CGCGGATCCCCACAGT GATCCCCAC [SEQ. ID. NO: 38] [SEQ. ID. NO: 39] K35M GGCCACTTTGTGGCCCTCATGAGT ATTGGGGACTCTCACACTCATGAG GTGAGAGTCCCCAAT GGCCACAAAGTGGCC [SEQ. ID. NO: 40] [SEQ. ID. NO: 41] K35R GGCCACTTTGTGGCCCTCAGGAGT ATTGGGGACTCTCACACTCCTGAG GTGAGAGTCCCCAAT GGCCACAAAGTGGCC [SEQ. ID. NO: 42] [SEQ. ID. NO: 43] K155Q ACAAGTGGTGGAACAGTCCAGCT CAGGCCAAAGTCAGCCAGCTGGA GGCTGACTTTGGCCTG CTGTTCCACCACTTGT [SEQ. ID. NO: 44] [SEQ. ID. NO: 45] D158R GTAGATTCTGGCCAGGCCAAACC GGTGGAACAGTCAAGCTGGCTCG GAGCCAGCTTGACTGTTCCACC GTTTGGCCTGGCCAGAATCTAC [SEQ. ID. NO: 46] [SEQ. ID. NO: 47] D158Q GGAACAGTCAAGCTGGCTCAGTT GATTCTGGCCAGGCCAAACTGAG TGGCCTGGCCAGAATC CCAGCTTGACTGTTCC [SEQ. ID. NO: 48] [SEQ. ID. NO: 49] D158A GGAACAGTCAAGCTGGCTGCCTTT GATTCTGGCCAGGCCAAAGGCAG GGCCTGGCCAGAATC CCAGCTTGACTGTTCC [SEQ. ID. NO: 50] [SEQ. ID. NO: 51] D158D GGAACAGTCAAGCTGGCTGATTTT GATTCTGGCCAGGCCAAAATCAG GGCCTGGCCAGAATC CCAGCTTGACTGTTCC [SEQ. ID. NO: 52] [SEQ. ID. NO: 53] D158Y GGAACAGTCAAGCTGGCTTACTTT GATTCTGGCCAGGCCAAAGTAAG GGCCTGGCCAGAATC CCAGCTTGACTGTTCC [SEQ. ID. NO: 54] [SEQ. ID. NO: 55] D158N GGAACAGTCAAGCTGGCTTACTTT GATTCTGGCCAGGCCAAAGTAAG GGCCTGGCCAGAATC CCAGCTTGACTGTTCC [SEQ. ID. NO: 56] [SEQ. ID. NO: 57] S285C CCACACAAGCGAATCTGTGCCTTT CAGAGCTCGAAAGGCACAGATTC CGAGCTCTG GCTTGTGTGG [SEQ. ID. NO: 58] [SEQ. ID. NO: 59] L161L AAGCTGGCTGACTTTGGCTTGGCC GTAGCTGTAGATTCTGGCCAAGCC AGAATCTACAGCTAC AAAGTCAGCCAGCTT [SEQ. ID. NO: 60] [SEQ. ID. NO: 61] V137I CTTCATGCCAATTGCATCATTCAC TGGCTTCAGATCTCGGTGAATGAT CGAGATCTGAAGCCA GCAATTGGCATGAAG [SEQ. ID. NO: 62] [SEQ. ID. NO: 63] V174M CAGATGGCACTTACACCCATGGTT GTACCAGAGTGTAACAACCATGG GTTACACTCTGGTAC GTGTAAGTGCCATCTG [SEQ. ID. NO: 64] [SEQ. ID. NO: 65] V174G CAGATGGCACTTACACCCGGGGT GTACCAGAGTGTAACAACCCCGG TGTTACACTCTGGTAC GTGTAAGTGCCATCTG [SEQ. ID. NO: 66] [SEQ. ID. NO: 67]

TABLE 4B Primers for site-directed mutagenesis of CDK6 CDK6 mutant Forward Primer Reverse Primer R31C GGGAAGGTGTTCAAGGCCTGCGA GCCTCCGTTCTTCAAGTCGCAGGC CTTGAAGAACGGAGGC CTTGAACACCTTCCC [SEQ. ID. NO: 68] [SEQ. ID. NO: 69] K43M GGCCGTTTCGTGGCGTTGATGCGC GGTCTGCACCCGCACGCGCATCA GTGCGGGTGCAGACC ACGCCACGAAACGGCC [SEQ. ID. NO: 70] [SEQ. ID. NO: 71] R144H CACCGAGTAGTGCATCACGATCT CTGTGGTTTTAGATCGTGATGCAC AAAACCACAG TACTCGGTG [SEQ. ID. NO: 72] [SEQ. ID. NO: 73] D163N GGACAAATAAAACTCGCTAACTT GATGCGGGCAAGGCCGAAGTTAG CGGCCTTGCCCGCATC CGAGTTTTATTTGTCC [SEQ. ID. NO: 74] [SEQ. ID. NO: 75] P199L TCCAGCTACGCCACCCTCGTGGAT ACTCCAGAGATCCACGAGGGTGG CTCTGGAGT CGTAGCTGGA [SEQ. ID. NO: 76] [SEQ. ID. NO: 77] R220C CGTAGAAAGCCTCTTTTTTGTGGA ATCAACATCTGAACTTCCACAAAA AGTTCAGATGTTGAT AAGAGGCTTTCTACG [SEQ. ID. NO: 78] [SEQ. ID. NO: 79] R220S CGTAGAAAGCCTCTTTTTAGTGGA ATCAACATCTGAACTTCCACTAAA AGTTCAGATGTTGAT AAGAGGCTTTCTACG [SEQ. ID. NO: 80] [SEQ. ID. NO: 81]

Example 15 Using Potential Resistant CDK4/6 Mutants to Check the Assay

Since there is no information regarding CDK4 or CDK6 mutations causing drug resistance, potential resistant mutants were created based on available crystal structures of CDK4 and CDK6 with CyclinD1 and Ribociclib. Computer modeling was used to reveal the drug-binding pocket and predict drug-resistant mutants. The mutations in CDK4 and CDK6 were created by site-directed mutagenesis. The primers are indicated in Table 5. WT or mutated CDK4 or CDK6 along with the CyclinD1 and SB-Rb was co-transfected into #11 cell line, under the same conditions as previously indicated. A summary of all predicted CDK4 and CDK6 mutants that can affect either ATP, or CyclinD1 binding is presented in Table 6. Of the mutations created, two mutants for CDK4, F93I and T102K, and one mutant for CDK6, T107K, showed drug resistance. Dose response curves are presented on FIG. 13A and FIG. 13B. Activity of other mutants was very similar to the WT or KD. Mutants T102K for CDK4 or T107K for CDK6 do not directly interact with either Palbociclib or Ribociclib, but mutation of Thr to Lys places the positively charged Lys amino group in proximity to the positively charged amino group of both Palbociclib and Ribociclib, leading to an electrostatic repulsion and thus drug displacement (FIG. 14 ).

TABLE 5A Primers for site-directed mutagenesis of predicted CDK4 mutants causing resistance CDK4 mutant Forward Primer Reverse Primer A162V CTGGCTGACTTTGGCCTGGTCAG CATCTGGTAGCTGTAGATTCTGAC AATCTACAGCTACCAGATG CAGGCCAAAGTCAGCCAG [SEQ. ID. NO: 82] [SEQ. ID. NO: 83] I51F GGTGGAGGAGGCCTTCCCtTCAGC CACCTCACGAACTGTGCTGAaGGG ACAGTTCGTGAGGTG AAGGCCTCCTCCACC [SEQ. ID. NO: 84] [SEQ. ID. NO: 85] T102K GTAGACCAGGACCTAAGGAaATA GGGTGCCTTGTCCAGATATtTCCTT TCTGGACAAGGCACCC AGGTCCTGGTCTAC [SEQ. ID. NO: 86] [SEQ. ID. NO: 87] T102R CATGTAGACCAGGACCTAAGGAg GGGTGCCTTGTCCAGATATcTCCT ATATCTGGACAAGGCACCC TAGGTCCTGGTCTACATG [SEQ. ID. NO: 88] [SEQ. ID. NO: 89] L49R GGAGGAGGTGGAGGAGGCCgTCC ACGAACTGTGCTGATGGGAcGGCC CATCAGCACAGTTCGT TCCTCCACCTCCTCC [SEQ. ID. NO: 90] [SEQ. ID. NO: 91] I12L TCTCGATATGAGCCAGTGGCTGA CCCATAGGCACCGACACCAAGTT ACTTGGTGTCGGTGCCTATGGG CAGCCACTGGCTCATATCGAGA [SEQ. ID. NO: 92] [SEQ. ID. NO: 93] G18A ATTGGTGTCGGTGCCTATGcGACA ACGGGCCTTGTACACTGTCgCATA GTGTACAAGGCCCGT GGCACCGACACCAAT [SEQ. ID. NO: 94] [SEQ. ID. NO: 95] A33S CACAGTGGCCACTTTGTGtCCCTC GACTCTCACACTCTTGAGGGaCAC AAGAGTGTGAGAGTC AAAGTGGCCACTGTG [SEQ. ID. NO: 96] [SEQ. ID. NO: 97] F93I ATCAAGGTAACCCTGGTGaTTGA GTCCTGGTCTACATGCTCAAtCAC GCATGTAGACCAGGAC CAGGGTTACCTTGAT [SEQ. ID. NO: 98] [SEQ. ID. NO: 99] A157S GGTGGAACAGTCAAGCTGtCTGA TCTGGCCAGGCCAAAGTCAGaCAG CTTTGGCCTGGCCAGA CTTGACTGTTCCACC [SEQ. ID. NO: 100] [SEQ. ID. NO: 101]

TABLE 5B Primers for site-directed mutagenesis of predicted CDK6 mutants causing resistance CDK6 mutant Forward Primer Reverse Primer A162S AGCGGACAAATAAAACTCGtTGACT GCGGGCAAGGCCGAAGTCAaCGA TCGGCCTTGCCCGC GTTTTATTTGTCCGCT [SEQ. ID. NO: 102] [SEQ. ID. NO: 103] L152V CTAAAACCACAGAACATTgTGGTGA TTGTCCGCTGCTGGTCACCAcAAT CCAGCAGCGGACAA GTTCTGTGGTTTTAG [SEQ. ID. NO: 104] [SEQ. ID. NO: 105] T107K GTCGATCAAGACTTGACCAaaTACTT TGGAACTTTATCCAAGTAttTGGTC GGATAAAGTTCCA AAGTCTTGATCGAC [SEQ. ID. NO: 106] [SEQ. ID. NO: 107] D104N TTTGAACATGTCGATCAAaACTTGA ATCCAAGTAAGTGGTCAAGTtTTG CCACTTACTTGGAT ATCGACATGTTCAAA [SEQ. ID. NO: 108] [SEQ. ID. NO: 109] H100Y CTAACTTTAGTGTTTGAAtATGTCGA GGTCAAGTCTTGATCGACATaTTC TCAAGACTTGACC AAACACTAAAGTTAG [SEQ. ID. NO: 110] [SEQ. ID. NO: 111] F98I ACCAAACTAACTTTAGTGaTTGAAC GTCTTGATCGACATGTTCAAtCACT ATGTCGATCAAGAC AAAGTTAGTTTGGT [SEQ. ID. NO: 112] [SEQ. ID. NO: 113] A41V AACGGAGGCCGTTTCGTGGtGTTGA CACCCGCACGCGCTTCAACaCCAC AGCGCGTGCGGGTG GAAACGGCCTCCGTT [SEQ. ID. NO: 114] [SEQ. ID. NO: 115] V27A GAGGGCGCCTATGGGAAGGcGTTCA CAAGTCGCGGGCCTTGAACgCCTT AGGCCCGCGACTTG CCCATAGGCGCCCTC [SEQ. ID. NO: 116] [SEQ. ID. NO: 117] I19L TACGAATGCGTGGCGGAGcTCGGGG CCCATAGGCGCCCTCCCCGAgCTC AGGGCGCCTATGGG CGCCACGCATTCGTA [SEQ. ID. NO: 118] [SEQ. ID. NO: 119]

TABLE 6A Summary table of predicted drug resistant CDK4 mutants Litera- ture F931 ref. T102K A33S F93I G18A A157S T102R L49R I51F A162V I12L T102K COSMIC * * database count  1  1 type of squamous uterine cancer cell corpus carcinoma end. carcinoma Observed Resistant Resistant KD KD Resistant drug resist. Luc. 162 182 157 97.5 195 156 281 160 254 126 152 activity (/wt)

TABLE 6B Summary table of predicted drug resistant CDK6 mutants Litera- ture ref. T107K I19L F98I D104N L152V A41V H100Y A162V V27A COSMIC database count type of cancer Observed Resistant drug resist. Luc. 95 129 176 138 114 132 126 148 149 activity (/wt)

Example 16 Assay Validation by Using COSMIC Mutations and Creating Our Own Database

CDK4 and CDK6 mutants with known function and unknown function taken from the COSMIC database were analyzed in the present assay and are summarized in Table 7A and Table 7B. The mutants were classified according to their activity. Table 7A and Table 7B also show the number of counts per mutant in the COSMIC database, type of cancer, and luciferase activity compared to the WT (being 100%).

TABLE 7A Summary table of all CDK4 mutants checked Literature ref. K22A R24A K35M COSMIC K22M R24S R24C K35R V137I database count  2 0  0  2  2  0  1  2 type of mela- mela- mela- uterine colon breast cancer noma noma noma carci- inv. noma carci- noma Reported Hyper Hyper KD activity Luc. 141 67.5 79 117 91 350 310 120 activity (/wt) Literature ref. D158N COSMIC K155Q D158Y L161L V174G V174M R210Q S285C database (C-T) count  1  1  0  2  1  1 2  2 type of prostate leukemia uterine oral colo- gall- cancer carci- carci- rectal bladder noma noma carci- noma Reported KD activity Luc. 130 230 300 59 129 47 74.5 125 activity (/wt)

TABLE 7B Summary table of all CDK6 mutants checked Litera- ture ref. R31C K43M D163N COSMIC R144H P199L R220C R220S database count  0  0  2  0  2  2  1 type of colo- mela- colon colo- cancer rectal noma mela- rectal noma Reported Hyper KD KD activity Luc 66 468 267 408 565 164 271 activity (/wt)

Example 17 Next-Generation Sequencing to Interrogate Mutation of Tumor for Rb Assay

Since loss of Rb function is frequent in different types of cancer, knowing the gene mutations and drug resistance would be beneficial in cancer therapy. To survey the mutation status of the RB gene, whole exome sequencing was performed. Genomic DNA was extracted and used to prepare a library for NGS. The identified mutations, which caused changes in amino acid sequence, were picked to examine their functional effect on the gene in the cell-based assay described below. The patient gene carrying the identified mutation was constructed using a PCR mediated overlapping extension in the format of a linear expression cassette.

Example 18 Construction of Linear Expression Cassette of Human RB

In order to study the effect of unknown mutations in the human RB gene, a linear expression cassette containing the CMV promoter that controls RB expression and coding sequence of RB was generated followed by terminator and polyadenylation signaling. Overlapping extension PCR was employed to construct the linear expression cassette using expression plasmid of human RB as a PCR template. By employing this method, the construction of the linear expression cassette took around 4-8 hours in comparison to the traditional cloning method to generate expression plasmid which takes around 2-4 days. Therefore, making a patient gene in a linear expression cassette format was beneficial because of its quick turn-around time.

Example 19 Construction of Expression Plasmids for Rb Assay

The coding sequences of commercially-available cDNA plasmids encoding human RB and DP1 genes (Dharmacon) were amplified by PCR. Different restriction enzyme sites to forward and reverse primers, respectively, were inserted for purposes of cloning (Table 8). PCR products containing the coding sequences of human RB and DP1 were sub-cloned into the pcDNA 3.1 (+) vector. The nucleotide sequences of all genes were verified by DNA sequencing. Constructed RB expression plasmid was used as a PCR template to provide linear expression cassettes of wild-type (WT) or mutated forms of RB.

TABLE 8 Primers used for RB expression plasmids RB BamHI F TAATGGATCCGCCGCCACCATGCCGCCCAAAACC [SEQ. ID. NO: 120] RB XhoI R GCGGCTCGAGTCATTTCTCTTCCTTGTTTGAGG [SEQ. ID. NO: 121] DP1 NheI F TGGCTAGCCGCCACCATGGCAAAAGATGCCGGTCTAATT [SEQ. ID. NO: 122] DP1 XhoI R GACTCGAGTCAGTCGTCCTCGTCATTCTC [SEQ. ID. NO: 123]

Generation of Linear Expression Cassette of WT and Mutated RB

A linear expression cassette of human WT RB was generated by UF-CMV forward and BGH-UR reverse primers. The amplified products were gel-purified. The DNA concentration was quantitated by optical density at 260 nm using Nanodrop.

A linear expression cassette of mutated RB was generated by PCR via the mediated overlapping extension method. A pair of forward and reverse primers containing the targeted mutations was designed. The mutated codon (3 nucleotides) was located in the middle of the primer flanked by 18-21 nucleotides on each side. Two separate PCRs, named PCR #1 and PCR #2 in FIG. 15 , were performed using UF-CMV forward and mutated reverse primers, or mutated forward and BGH-UR primers, respectively. The PCR products were purified via ExoSAP-IT® (Affymetrix) to remove unconsumed dNTPs and primers. The two treated PCR products were mixed together and the mixture was diluted with water. A second round of PCR was performed using the diluted PCR mixture, and UF and UR primers (FIG. 15 ). The amplified products were gel-purified. The DNA concentration was quantitated by optical density at 260 nm using Nanodrop. The targeted mutations were successfully incorporated into the RB gene during the PCR mediated overlapping extension methods and confirmed by DNA sequencing.

Example 20 Transfection Method

In the described Rb assay, a so called reverse transfection protocol was used whereby freshly passaged HEK293 cells were added to the transfection complexes in order to reduce the hands-on time for the end user. In this scenario, the HEK293 cells were not adhered to the plate surface by the time they interacted with the transfection complexes.

Example 21 Interacting Partners for Rb Activity Assay

An assay that could measure the interaction between Rb, E2F1, and Dp-1 was developed. Since Dp-1 forms a heterodimer with E2F1 and that interaction is crucial for Rb/E2F1 binding, the assay was comprised of three components. When two proteins (Rb and E2F1) are in close proximity or in complex, a light signal was observed. For the purposes of the current assay, split-luciferase complementation was used to measure the interaction between Rb and E2F1. The NanoBiT assay system by Promega (Madison, Wis.; Dixon et al., 2015, ACS ChemBiol) was used in our split luciferase complementation design.

FIG. 16 depicts the design of a signal system to measure Rb activity. Under basal conditions inside the cell, Rb was active and interacted with the E2F1/Dp-1 heterodimer. For this assay design, cDNAs of Rb linked to different parts of the luciferase protein, either termed as the “Small BiT” (SB), or “Large BiT” (LB) and E2F1 linked to the opposite portion of the luciferase protein were created. When Rb and E2F1/Dp-1 bind, the NanoBiT parts of the luciferase form a complex and emitted a light signal when the luciferase (NanoGlo) substrate was added.

PCR was performed to ligate cDNAs fragments of RB and E2F1 into NanoBiT designed vectors MCS-1, MCS-2, MCS-3, and the MCS-4, respectively (Promega). Oligonucleotide primers used for subcloning are indicated in Table 9.

TABLE 9 Primers designed for subcloning RB and E2F1 cDNA constructs into NanoBiT vectors Target/Purpose Forward Primer Reverse Primer E2F1-LB, E2F1-SB CT AAGCTT GCC ACC ATG C AGA ATT CCC CTC CTC into MCS-1, MCS-2 CTC GAC TAC CAC TTC AGG GCA CAG GAA AAC using Hind III and EcoRI GGC CT [SEQ. ID. NO: 125] [SEQ. ID. NO: 124] RB-LB, RB-SB into MCS- CT AAGCTT GCC ACC ATG C AGA ATT CCC TTT CTC 1, MCS-2 using Hind III TAT GCT TCC ACC AGG TTC CTT GTT TGA GGT and EcoRI CCC CCT ATC CAT [SEQ. ID. NO: 126] [SEQ. ID. NO: 127] LB-E2F1, SB-E2F1 into AAT TCA CTAGG C GAC AC TCT AGA TTA CTC MCS-3, MCS-4 using TAC CAC TTC GGC CT CTC AGG GCA CAG GAA EcoRI and XbaI [SEQ. ID. NO: 128] AAC [SEQ. ID. NO: 129] LB-RB, SB-RB AGG AAT TCA TAT GCT AC TCT AGA TTA TTT into MCS-3, MCS-4 TCC ACC AGG CCC CCT CTC TTC CTT GTT TGA using EcoRI and XbaI [SEQ. ID. NO: 130] GGT ATC CAT [SEQ. ID. NO: 131]

Example 22 Designing Interacting Pairs for the Rb Assay

Using the described assay design, HEK293 CDK DKO cells were transiently transfected with different combinations of SB-Rb or LB-Rb and E2F1-LB or E2F1-SB components containing C-terminal and N-terminal constructs (FIG. 17 ). Relative intensities generated are presented in FIG. 17 as relative luminescence units (RLU). The data represents a sample experiment where each condition was performed in triplicate and represent mean+SD. According to the data, a higher luciferase activity was observed for the LB-Rb and E2F1-SB, DP1 constructs in Rb 379-928 activity assay, and Rb-LB and SB-E2F1, DP1 constructs for Rb full length activity assay (only used when there is a need for N-terminal Rb assessment).

Example 23 Rb Assay Validation by Using Known Null Mutants

The LB-Rb and E2F1-SB with Dp-1 were tested for Rb activity using known Rb null mutants: R661W and C706F (FIG. 18A). Rb point mutants R661W and C706F completely disrupted the E2F1 interaction and a resulting decrease in luciferase activity was observed. Rb in-frame (del35) and out-of frame (del1) deletion mutants (FIG. 18B) were constructed and the observed luciferase activity was close to 0, in particular for del1 mutant, because Rb-E2F1 binding was destroyed.

Example 24 Selection of Stable Cell Clones Carrying E2F1-SB and DP1

Within the provided assay design, stable cell lines using the HEK293 CDK DKO cell parent line expressing E2F1-SB and Dp-1 were produced. After selection and screening for positive clones using an LB-Rb-mediated increase in signal, four stable single cell clones were selected and evaluated using different Rb mutants (FIGS. 19A and 19B). The response to E2F1 interaction was also checked by using the plasmid and linear form of DNA. Cell line #37 was selected for all our experiments in assay development due to its favorable response.

Example 25 Rb Assay Optimization by Checking Different Cell Number and Rb Amount

The conditions of the assay were further optimized by analyzing different cell numbers and Rb concentrations (FIG. 20 ). Based on the data, it was decided to use 0.2×10⁶ cells/ml and 70 ng of DNA in the assay.

Example 26 Rb Assay Validation by Using Known Null and Deletion Mutants, as Well as Unknown COSMIC Mutants

Known null and out/in-frame deletion mutants disrupting E2F1 binding and unknown COSMIC mutants were created to examine the ability of the assay to detect variants in Rb that affect function. The primers are indicated in Table 10A and Table 10B. We transfected WT or mutated Rb using similar conditions as previously indicated (FIG. 20 ). Over-expression of WT LB-Rb exhibited a similarly observed increase in signal (FIG. 21 ). In addition, the null C706F and deletion (del1) mutants presented a signal close to zero as expected for loss of function mutants that disrupt E2F1 interaction. Some of the unknown COSMIC mutants demonstrated decreased or close to zero activity, other being as WT. Those unknown mutants with activity close to zero were checked by Western blot analysis and it was found that they had a decent protein expression level compared to the WT, but functionally they were inactive (FIGS. 22A and 22B). This confirmed that the assay was capable of determining the relative activity level of Rb mutants. The data is provided in Luminescence (RLU) of a single experiment with each condition performed in triplicate and represent average+SD.

A summary of all the Rb mutants checked to date is presented in Table 11.

TABLE 10A Primers for site-directed mutagenesis of RB (Rb379-928) activity assay Rb mutant Forward Primer Reverse Primer R661W TATCGGCTAGCCTATCTCTGGCTA TTCACAAAGTGTATTTAGCCAGAGA AATACACTTTGTGAA TAGGCTAGCCGATA [SEQ. ID. NO: 132] [SEQ. ID. NO: 133] C706F TTGGACCAAATTATGATGTTTTCC GCATATGCCATACATGGAAAACATC ATGTATGGCATATGC ATAATTTGGTCCAA [SEQ. ID. NO: 134] [SEQ. ID. NO: 135] E440K GTGGGACAGGGTTGTGTCAAAAT TGTATCGCTGTGATCCAATTTTGAC TGGATCACAGCGATACA ACAACCCTGTCCCAC [SEQ. ID. NO: 136] [SEQ. ID. NO: 137] A488V TTCATATGTCTTTATTGGTGTGCG ATTACAACCTCAAGAGCGCACACC CTCTTGAGGTTGTAAT AATAAAGACATATGAA [SEQ. ID. NO: 138] [SEQ. ID. NO: 139] R656W TTTTATAAAAAAGTGTATTGGCTA TAGCCGGAGATAGGCTAGCCAATA GCCTATCTCCGGCTA CACTTTTTTATAAAA [SEQ. ID. NO: 140] [SEQ. ID. NO: 141] R621S GAAAAAAGGTTCAACTACGAGTG CATTTGCAGTAGAATTTACACTCGT TAAATTCTACTGCAAATG AGTTGAACCTTTTTTC [SEQ. ID. NO: 142] [SEQ. ID. NO: 143] V654M TCACTGTTTTATAAAAAAATGTAT GAGATAGGCTAGCCGATACATTTTT CGGCTAGCCTATCTC TTATAAAACAGTGA [SEQ. ID. NO: 144] [SEQ. ID. NO: 145] L665R ATCTCCGGCTAAATACACGTTGTG CAGACAGAAGGCGTTCACAACGTG AACGCCTTCTGTCTG TATTTAGCCGGAGAT [SEQ. ID. NO: 146] [SEQ. ID. NO: 147] R798Q TTCCTAGTTCACCCTTACAGATTC AGATGTTCCCTCCAGGAATCTGTAA CTGGAGGGAACATCT GGGTGAACTAGGAA [SEQ. ID. NO: 148] [SEQ. ID. NO: 149] I680T CAGAATTAGAACATATCACCTGG TGTGCTGGAAAAGGGTCCAGGTGA ACCCTTTTCCAGCACA TATGTTCTAATTCTG [SEQ. ID. NO: 150] [SEQ. ID. NO: 151] R698W TATGAACTCATGAGAGACTGGCA CATAATTTGGTCCAAATGCCAGTCT TTTGGACCAAATTATG CTCATGAGTTCATA [SEQ. ID. NO: 152] [SEQ. ID. NO: 153] I724N ACCTTAAATTCAAAATCAATGTAA GATCCTTGTATGCTGTTACATTGAT CAGCATACAAGGATC TTTGAATTTAAGGT [SEQ. ID. NO: 154] [SEQ. ID. NO: 155] R798W TTCCTAGTTCACCCTTACAGATTC AGATGTTCCCTCCAGGAATCTGTAA CTGGAGGGAACATCT GGGTGAACTAGGAA [SEQ. ID. NO: 156] [SEQ. ID. NO: 157] I703del35 GAGACAGGCATTTGGACCAAACA GATCAAAACACGTTTGAATGTTTGG TTCAAACGTGTTTTGATC TCCAAATGCCTGTCTC [SEQ. ID. NO: 158] [SEQ. ID. NO: 159] R661del1 GATCAAAACACGTTTGAATGTTTG CGTTCACAAAGTGTATTTAGAGATA GTCCAAATGCCTGTCTC GGCTAGCCGATACA [SEQ. ID. NO: 160] [SEQ. ID. NO: 161]

TABLE 10B Primers for site-directed mutagenesis of full-length RB (Rb1-928) activity assay Rb mutant Forward Primer Reverse Primer R147V AGTACCAAAGTTGATAATGTTAT CTTCAACAGTCTTGACATAACAT GTCAAGACTGTTGAAG TATCAACTTTGGTACT [SEQ. ID. NO: 162] [SEQ. ID. NO: 163] V144S ATTGATACCAGTACCAAAAGTGA TCTTGACATAGCATTATCACTTT TAATGCTATGTCAAGA TGGTACTGGTATCAAT [SEQ. ID. NO: 164] [SEQ. ID. NO: 165] G100A AAGAAAAAGGAACTGTGGGCAA TGCAATAAAGATACAGATTGCC TCTGTATCTTTATTGCA CACAGTTCCTTTTTCTT [SEQ. ID. NO: 166] [SEQ. ID. NO: 167] G100R AAGAAAAAGGAACTGTGGAGAA TGCAATAAAGATACAGATTCTCC TCTGTATCTTTATTGCA ACAGTTCCTTTTTCTT [SEQ. ID. NO: 168] [SEQ. ID. NO: 169] T373A ATGTAATTCCTCCACACAGCCCA TCATAACAGTCCTAACTGGGCTG GTTAGGACTGTTATGA TGTGGAGGAATTACAT [SEQ. ID. NO: 170] [SEQ. ID. NO: 171] T373E ATGTAATTCCTCCACACAATCCA TCATAACAGTCCTAACTGGATTG GTTAGGACTGTTATGA TGTGGAGGAATTACAT [SEQ. ID. NO: 172] [SEQ. ID. NO: 173] P374A GTAATTCCTCCACACACTGCAGT GTTCATAACAGTCCTAACTGCAG TAGGACTGTTATGAAC TGTGTGGAGGAATTAC [SEQ. ID. NO: 174] [SEQ. ID. NO: 175] I185T AGTTCGATATCTACTGAAACAAA TAGCACCAATGCAGAATTTGTTT TTCTGCATTGGTGCTA CAGTAGATATCGAACT [SEQ. ID. NO: 176] [SEQ. ID. NO: 177] S187T ATATCTACTGAAATAAATACTGC AACTTTTAGCACCAATGCAGTAT ATTGGTGCTAAAAGTT TTATTTCAGTAGATAT [SEQ. ID. NO: 178] [SEQ. ID. NO: 179] E137D CTTTAACTTACTAAAAGATATTG ACTTTGGTACTGGTATCAATATC ATACCAGTACCAAAGT TTTTAGTAAGTTAAAG [SEQ. ID. NO: 180] [SEQ. ID. NO: 181]

TABLE 11 Summary of the activity level of Rb mutants investigated Liter. ref R661W C706F COSMIC R661W I680T A488V R656W R698W C706F E440K L665R database count 10  9  5  5 4 4  4 4 Type bladder thyroid bladder colo- medullo- Small- bladder Small- of colorect. rectal blastoma cell cell cancer lung mela- lung lung noma Observed N R R A N N R N activity % (/wt) 5.2 32 51 79 6.4 5.5 47 5 Liter. I703 ref del35 COSMIC R621S V654M R661fs* I724N I703del R798W R798Q database count  3  3 3 3 2  2  2 Type lym- glioblas- Small- bladder Ovarian ovarian colorectal of phoma toma cell prostatic cancer lung Observed A A N N N A A activity % (/wt) 124 132 0.8 7.4 8.6 120 92 N—no activity A—active as WT R—reduced activity compared to the WT

Example 27 Next-Generation Sequencing to Interrogate Mutation of Tumor for p16 Activity Assay

Since loss of p16 function is frequent in different types of cancer, knowing the gene mutations would be beneficial in cancer therapy. To survey the mutation status of the CDKN2A gene, whole exome sequencing was performed. Genomic DNA was extracted and used to prepare a library for next-generation sequencing. The identified mutations, which caused a change in amino acid sequence, were picked to examine their functional effect on the gene in a cell-based assay described herein. The patient gene carrying the identified mutation was constructed using PCR mediated overlapping extension in the format of linear expression cassette.

Example 28 Construction of Linear Expression Cassette of Human CDKN2A

In order to study the effect of unknown mutations in the human CDKN2A gene, a linear expression cassette was generated that contained a CMV promoter that controls CDKN2A expression and a coding sequence of CDKN2A followed by terminator and polyadenylation signal. Overlapping extension PCR was employed to construct the linear expression cassette using an expression plasmid of human CDKN2A as a PCR template. Under this method, the construction of linear expression cassette takes around 4-8 hours, while the traditional cloning method to generate expression plasmid takes around 2-4 days. Therefore, a patient gene in a linear expression cassette format is beneficial for the clinical diagnostic test because of its quick turn-around time.

Example 29 Generation of Linear Expression Cassette of WT and Mutated CDKN2A

A cDNA plasmid encoding human CDKN2A gene was (GenScript) used as a PCR template to provide linear expression cassettes of WT or mutated forms of CDKN2A.

A linear expression cassette of human WT CDKN2A was generated by UF-CMV forward and BGH-UR reverse primers. The amplified products were gel-purified. The DNA concentration was quantitated by the optical density at 260 nm using Nanodrop.

A linear expression cassette of mutated CDKN2A was generated by PCR mediated overlapping extension method. A pair of forward and reverse primers containing the targeted mutations was designed. The mutated codon was located in the middle of the primer flanked by 18-21 nucleotides in each side. Two separate PCRs, named as PRC #1 and PCR #2, were performed separately using UF-CMV forward and mutated reverse primers and mutated forward and BGH-UR primers were (FIG. 23 ). ExoSAP-IT® (Affymetrix) was used on the PCR products to remove unconsumed dNTPs and primers. The treated PCR products were mixed together followed by dilution with water. A second round of PCR analysis was performed using the diluted PCR mixture, and UF and UR primers (FIG. 23 ). The amplified products were gel-purified. The DNA concentration was quantitated by the optical density at 260 nm using Nanodrop. The targeted mutations were successfully incorporated in the CDKN2A gene during the PCR mediated overlapping extension method. The introduced mutations were confirmed by the DNA sequencing.

Example 30 Transfection Method

HEK293 cells are a specific cell line originally derived from human embryonic kidney cells grown in tissue culture. HEK293 cells have been widely used in cell biology research for many years because of their reliable growth and propensity for transfection. In general, there are two major types of transfection, forward and reverse.

A reverse transfection protocol was used as it reduced hands-on time for the end user. In this protocol, freshly passaged cells were added to the transfection complexes. In this scenario, cells were not adhered to the plate surface by the time they interacted with the transfection complexes.

Example 31 NanoBit Approach for p16 Activity Assay

We developed an assay that could measure the interaction between Rb, E2F1 and Dp-1. When the Rb and E2F1 proteins are in close proximity or in complex, a light signal is observed. For the purpose of the assay, split-luciferase complementation was used to measure the interaction between Rb and E2F1, which served as a surrogate measure of CDK4/6 activity and the ability of CDK4/6 to respond to the natural inhibitor p16. The NanoBiT assay system by Promega (Madison, Wis.; Dixon et al., 2015, ACS ChemBiol) was used in the split luciferase complementation design. FIG. 24 depicts a design of a signal system to measure p16 activity. Under basal conditions inside the cell, Rb is active and interacts with the E2F1/Dp-1 heterodimer. However, in the presence of the CDK4 or CDK6, Rb gets phosphorylated and released from the interacting complex. In the presence of the natural inhibitor p16, CDK4/6 is no longer available to phosphorylate Rb and thus promoting the Rb/E2F1-Dp-1 complex formation.

Example 32 p16 Activity Assay Validation

For the purpose of the current assay, the stable cell line #11 that we generated for the CDK activity assay was used and described above. HEK293 CDK DKO cells containing E2F1-Dp-1-LB was transiently transfected with CDK4/CDK6, CyclinD1, and SB-Rb. The transfected cells were then exposed to the natural inhibitor p16 (FIG. 25 ). When CDK4 or CDK6 is present, a decrease in activity was observed as Rb gets phosphorylated resulting in no Rb/E2F1-Dp-1 interaction. With treatment of p16, an increase in luminescence was observed, which is consistent with a decrease in CDK4/6 activity resulting in an increased interaction between SB-Rb and E2F1-Dp-1-LB. The data presented was a sample experiment where each condition was performed in triplicate and represented mean+SD.

Example 33 p16 Activity Assay Optimization

The conditions of the assay were optimized by using different p16 amounts and cell numbers (FIGS. 25A and 25B). Based on the data generated, it was decided that using 0.2×10⁶ cells/ml and 10 ng of p16 would be preferable.

Example 34 p16 Activity Assay Validation by Using Known Loss of Function and Unknown COSMIC Mutants

To examine the ability of the assay to detect variants in CDKN2A that affect function, known loss of function mutants and unknown COSMIC mutants were created. The primers used are indicated in Table 12. Wild-type or mutated CDKN2A were prepared in a manner similar to that previously indicated. Over-expression of WT p16 exhibited the previously observed increase in signal (FIG. 26 ). In addition, the loss of function mutants (A20P, V126D, H83Y, and P114L) generated a signal close to the baseline as expected for loss of function mutants. Some of the COSMIC mutants with unreported functions generated decreased or close to the baseline activity, while other COSMIC mutants were as active as WT or higher. Therefore the p16 activity assay is capable of determining the relative activity level of p16 mutants. The data provided is in Luminescence (RLU) of a single experiment with each condition performed in triplicate and represent average+SD. Summary Table 13 reports p16 mutants tested.

TABLE 12 Primers for site-directed mutagenesis of CDKN2A p16 mutant Forward Primer Reverse Primer H83Y ACTCTCACCCGACCCGTGTACGAC GCCCTCCCGGGCAGCGTCGTACACG GCTGCCCGGGAGGGC GGTCGGGTGAGAGT [SEQ. ID. NO: 182] [SEQ. ID. NO: 183] P114L ATGCCTGGGGCCGTCTGCTCGTGG GCTCCTCAGCCAGGTCCACGAGCAG ACCTGGCTGAGGAGC ACGGCCCCAGGCAT [SEQ. ID. NO: 184] [SEQ. ID. NO: 185] A36G GCGCTGCTGGAGGCGGGGGGGCTG ATTCGGTGCGTTGGGCAGCCCCCCC CCCAACGCACCGAAT GCCTCCAGCAGCGC [SEQ. ID. NO: 186] [SEQ. ID. NO: 187] V126D GAGCTGGGCCATCGCGATGACGCA CGCGCGCAGGTACCGTGCGTCATCG CGGTACCTGCGCGCG CGATGGCCCAGCTC [SEQ. ID. NO: 188] [SEQ. ID. NO: 189] M53I CGGAGGCCGATCCAGGTCATGATA CGCCACTCGGGCGCTGCCCATTATC ATGGGCAGCGCCCGAGTGGCG ATGACCTGGATCGGCCTCCG [SEQ. ID. NO: 190] [SEQ. ID. NO: 191] R24P ACGGCCGCGGCCCGGGGTCCGGTA CGCCCGCACCTCCTCTACCGGACCC GAGGAGGTGCGGGCG CGGGCCGCGGCCGT [SEQ. ID. NO: 192] [SEQ. ID. NO: 193] A20P GACTGGCTGGCCACGGCCCCGGCC CTCTACCCGACCCCGGGCCGGGGCC CGGGGTCGGGTAGAG GTGGCCAGCCAGTC [SEQ. ID. NO: 194] [SEQ. ID. NO: 195] A148T CATGCCCGCATAGATGCCACGGAA GATGTCTGAGGGACCTTCCGTGGCA GGTCCCTCAGACATC TCTATGCGGGCATG [SEQ. ID. NO: 196] [SEQ. ID. NO: 197] S56N CAGGTCATGATGATGGGCAACGCC CAGCTCCGCCACTCGGGCGTTGCCC CGAGTGGCGGAGCTG ATCATCATGACCTG [SEQ. ID. NO: 198] [SEQ. ID. NO: 199] S56I ATCCAGGTCATGATGATGGGCATC CAGCAGCTCCGCCACTCGGGCGATG GCCCGAGTGGCGGAGCTGCTG CCCATCATCATGACCTGGAT [SEQ. ID. NO: 200] [SEQ. ID. NO: 201] G101W GTGGTGCTGCACCGGGCCTGGGCG GCGCACGTCCAGCCGCGCCCAGGC CGGCTGGACGTGCGC CCGGTGCAGCACCAC [SEQ. ID. NO: 202] [SEQ. ID. NO: 203] R144C AGAGGCAGTAACCATGCCTGCATA ACCTTCCGCGGCATCTATGCAGGCA GATGCCGCGGAAGGT TGGTTACTGCCTCT [SEQ. ID. NO: 204] [SEQ. ID. NO: 205] D14G AGCATGGAGCCTTCGGCTGGCTGG CGCGGCCGTGGCCAGCCAGCCAGC CTGGCCACGGCCGCG CGAAGGCTCCATGCT [SEQ. ID. NO: 206] [SEQ. ID. NO: 207] G35E CGGGCGCTGCTGGAGGCGGAGGC CGGTGCGTTGGGCAGCGCCTCCGCC GCTGCCCAACGCACCG TCCAGCAGCGCCCG [SEQ. ID. NO: 208] [SEQ. ID. NO: 209] D108N GCGCGGCTGGACGTGCGCAATGCC GGGCAGACGGCCCCAGGCATTGCG TGGGGCCGTCTGCCC CACGTCCAGCCGCGC [SEQ. ID. NO: 210] [SEQ. ID. NO: 211]

TABLE 13 Summary table of all CDKN2A mutants checked p16 A20P R24P M53I V126D H83Y P114L A148T Cosmic 3 6 3 2 58 46 3 count Type melanoma osteo- thyroid pancreatic squamous melanoma melanoma of bladder sarcoma carcinoma melanoma carcinoma skin pancreatic cancer prostate glioblas- melanoma pancreatic cancer kidney toma lung bladder carcinoma leukemia cancer cancer breast squamous cancer cell melanoma carcinoma bladder lung cancer cancer leukemia Literature Loss of Loss of Loss of Loss of Loss of Loss of Normal reported function function function function function function function Observed Loss of Loss of Loss of Loss of Loss of Loss of Normal function function function function function function function p16 S56N D14G G35E D108N A36G G101W R144C Cosmic 1 1 3 10 10 4 0 count Type ampullary squamous melanoma bladder skin squamous of carcinoma cell squamous melanoma cell cancer carcinoma cell head, carcinoma carcinoma neck liver colorectal cancer cancer endometrial kidney breast carcinoma cancer lung squamous carcinoma biliary tract cancer head and neck squamous cell carcinoma Literature Not Not Not Not Not Loss of Normal reported reported reported reported reported reported function function Observed Normal Normal Loss of Normal Normal Reduced Normal function function

Example 35 p16 Activity Assay Validation Using Different CDK4 and CDK6 Mutants

In addition to check functional state of p16 mutants, p16 activity assay can be used to look at p16 inhibition response of different CDK4 and CDK6 mutants. Different response of WT CDK4 and CDK6 and hyperactive mutants of CDK4 (R24A) and CDK6 (R31C) is shown on FIG. 28 . As expected for hyperactive mutants (due to their less binding to natural inhibitor p16) a decreased level of luminescence was observed, consistent with a decrease in CDK binding to p16. The p16 activity assay is so sensitive and specific that hyperactive CDK4 and CDK6 mutants can show different response to mutant p16. For example, p16 A36G mutant being normal functionally showed different inhibition for R24A CDK4 mutant compared to the WT (FIG. 29 ). 

What is claimed is:
 1. A method of determining the activity of a Rb variant in a cell, comprising the steps of: a. providing a mammalian cell, said cell comprising a stably integrated first construct, wherein said first construct comprises a first cDNA encoding E2F1 protein which is linked to a first portion of a luciferase gene, and a second cDNA encoding Dp-1 protein; b. preparing a linear third cDNA of a Rb variant, wherein said Rb variant contains at least one mutation as compared to wild-type Rb, and said third cDNA is linked to a second portion of a luciferase gene to form a second construct, wherein when said first construct is in close proximity with said second construct a complex is formed that emits light; c. transfecting said second construct into said mammalian cell; and d. determining the activity of said Rb variant by measuring any generated light emission, wherein an increase in light emission relative to a control mammalian cell is indicative of said Rb variant activity.
 2. A method of determining the activity of a p16 variant in a cell comprising the steps of: a. providing a mammalian cell, said cell having a knockout of endogenous CDK4 and endogenous CDK6, and a first construct stably integrated into said mammalian cell comprising a first cDNA encoding E2F1 protein linked to Dp-1 protein and a first portion of a luciferase gene at its C-terminus; b. preparing a second construct comprising a second cDNA encoding Rb protein which is linked to a second portion of a luciferase gene at its N-terminus, wherein when said first construct is in close proximity with said second construct a complex is formed that emits light; c. preparing a third cDNA encoding Cyclin D1 protein and a fourth cDNA encoding CDK4 protein or CDK6 protein; d. preparing a fifth cDNA of a CDKN2A variant, said CDKN2A variant having at least one mutation as compared to wild-type CDKN2A; e. preparing a transfection complex, said transfection complex comprising said second construct, said third cDNA, said fourth cDNA, and said fifth cDNA; f. transfecting said transfection complex into said mammalian cell, wherein said transfection is transient; and g. determining the activity of said p16 variant by measuring any generated light emission, wherein an increase in light emission relative to a mammalian cell control is indicative of said p16 variant activity.
 3. A method of determining the sensitivity of a CDK4 variant or a CDK6 variant to p16 in a cell, comprising the steps of: a. providing a mammalian cell, said cell having a knockout of endogenous CDK4 and endogenous CDK6, and a first construct stably integrated into said cell, said first construct comprising a first cDNA encoding E2F1 protein linked to Dp-1 protein, wherein said Dp-1 protein is linked to a first portion of a luciferase gene at its C-terminus; b. preparing a second cDNA of a CDK4 or CDK6 variant from a patient, said CDK4 variant or CDK6 variant containing at least one mutation as compared to wild-type CDK4 or wild-type CDK6; c. preparing a second construct comprising a third cDNA encoding Rb protein which is linked to a second portion of a luciferase gene at its N-terminus, wherein when said first construct is in close proximity with said second construct a complex is formed that emits light; d. preparing a fourth cDNA encoding Cyclin D1 protein; e. preparing a fifth cDNA of wild-type CDKN2A; f. preparing a transfection complex comprising said second construct, said third cDNA, said fourth cDNA, and said fifth cDNA; g. transfecting said transfection complex into said mammalian cell, wherein said transfection is transient; and h. determining whether said CDK4 or CDK6 variant is sensitive to p16 by measuring any generated light emission, wherein an increase in light emission relative to a mammalian cell control is indicative of said CDK4 or CDK6 variant being sensitive to p16. 